Amended in Senate April 26, 2016

Amended in Senate March 29, 2016

Senate BillNo. 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:

P2    1

SECTION 1.  

The Legislature finds and declares all of the
2following:

3(a) 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(b) 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 TRC is hereby recognized
18as the State Pilot Trauma Recovery Center (State Pilot TRC). The
19State Pilot TRC was established by the Legislature as a four-year
20demonstration project to develop and test a comprehensive model
21of care as an alternative to fee-for-service care reimbursed by
22victim restitution funds. It was designed to increase access for
23crime victims to these funds.

P3    1(c) The results of this four-year demonstration project have
2established that the State Pilot TRC model was both clinically
3effective and cost effective when compared to customary
4fee-for-service care. Seventy-seven percent of victims receiving
5trauma recovery center services engaged in mental health treatment,
6compared to 34 percent receiving customary care. The State Pilot
7TRC model increased the rate by which sexual assault victims
8received mental health services from 6 percent to 71 percent,
9successfully linked 53 percent to legal services, 40 percent to
10vocational services, and 31 percent to safer and more permanent
11housing. Trauma recovery center services cost 34 percent less than
12customary care.

13(d) California voters approved Proposition 47, known as the
14Safe Neighborhoods and Schools Act of 2014. The measure was
15enacted to ensure that prison spending is focused on violent and
16serious offenses to maximize alternatives for nonviolent and
17 nonserious crimes and to invest the resulting savings into
18prevention and support programs.

19(e) The Safe Neighborhoods and Schools Actbegin insert of 2014end insert requires
2010 percent of the moneys in the Safe Neighborhoods and Schools
21Fund to be allocated to the California Victim Compensation
22Program to administer a grant program to establish trauma recovery
23centers modeled after the UCSF TRC.

24(f) Systematic training, technical assistance, and ongoing
25standardized program evaluations are needed to ensure that all
26new state-funded trauma recovery centers are evidence-based,
27accountable, clinically effective, and cost effective.

28(g) By creating the Trauma Recovery Center of Excellence, it
29is the intent of the Legislature that these services will be delivered
30in a clinically effective and cost-effective manner, and that the
31victims of crime in California will have increased access to needed
32 services.

33

SEC. 2.  

Section 13963.1 of the Government Code is amended
34to read:

35

13963.1.  

(a) The Legislature finds and declares all of the
36following:

37(1) Without treatment, approximately 50 percent of people who
38survive a traumatic, violent injury experience lasting or extended
39psychological or social difficulties. Untreated psychological trauma
40often has severe economic consequences, including overuse of
P4    1costly medical services, loss of income, failure to return to gainful
2employment, loss of medical insurance, and loss of stable housing.

3(2) Victims of crime should receive timely and effective mental
4health treatment.

5(3) The board shall administer a program to evaluate applications
6and award grants to trauma recovery centers.

7(b) The board shall award a grant only to a trauma recovery
8center that meets all of the following criteria:

9(1) The trauma recovery center demonstrates that it serves as a
10community resource by providing services, including, but not
11limited to, making presentations and providing training to law
12enforcement, community-based agencies, and other health care
13providers on the identification and effects of violent crime.

14(2) Any other related criteria required by the board, including
15those developed pursuant to subdivision (c) of Section 13963.4.

16(3) The trauma recovery center uses the core elements
17established in Section 13963.2.

18(c) It is the intent of the Legislature to provide an annual
19appropriation of two million dollars ($2,000,000) perbegin delete year. All
20grants awarded by the board shall be funded onlyend delete
begin insert yearend insert from the
21Restitution Fund.

22(d) The board may award a grant providing funding for up to a
23maximum period of three years. Any portion of a grant that a
24trauma recovery center does not use within the specified grant
25period shall revert to the Restitution Fund. The board may award
26consecutive grants to a trauma recovery center to prevent a lapse
27in funding.

28(e) The board, when considering grant applications, shall give
29preference to a trauma recovery center that conducts outreach to,
30and serves, both of the following:

31(1) Crime victims who typically are unable to access traditional
32services, including, but not limited to, victims who are homeless,
33chronically mentally ill, of diverse ethnicity, members of immigrant
34and refugee groups, disabled, who have severe trauma-related
35symptoms or complex psychological issues, or juvenile victims,
36including minors who have had contact with the juvenile
37dependency or justice system.

38(2) Victims of a wide range of crimes, including, but not limited
39to, victims of sexual assault, domestic violence, physical assault,
P5    1shooting, stabbing, human trafficking, and vehicular assault, and
2family members of homicide victims.

3(f) The trauma recovery center sites shall be selected by the
4board through a well-defined selection process that takes into
5account the rate of crime and geographic distribution to serve the
6greatest number of victims.

7(g) A trauma recovery center that is awarded a grant shall do
8both of the following:

9(1) Report to the board annually on how grant funds were spent,
10how many clients were served (counting an individual client who
11receives multiple services only once), units of service, staff
12productivity, treatment outcomes, and patient flow throughout
13both the clinical and evaluation components of service.

14(2) In compliance with federal statutes and rules governing
15federal matching funds for victims’ services, each center shall
16submit any forms and data requested by the board to allow the
17board to receive the 60 percent federal matching funds for eligible
18victim services and allowable expenses.

19(h) For purposes of this section, a trauma recovery center
20provides, including, but not limited to, all of the following
21resources, treatments, and recovery services to crime victims:

22(1) Mental health services.

23(2) Assertive community-based outreach and clinical case
24management.

25(3) Coordination of care among medical and mental health care
26providers, law enforcement agencies, and other social services.

27(4) Services to family members and loved ones of homicide
28victims.

29(5) A multidisciplinary staff of clinicians that includes
30psychiatrists, psychologists, social workers, case managers, and
31peer counselors.

32

SEC. 3.  

Section 13963.2 is added to the Government Code, to
33read:

34

13963.2.  

The Trauma Recovery Center at the San Francisco
35General Hospital, University of California, San Francisco, is
36recognized as the State Pilot Trauma Recovery Center (State Pilot
37TRC). The California Victim Compensation and Government
38Claims Board shall use the evidence-based Integrated Trauma
39Recovery Services (ITRS) model developed by the State Pilot TRC
40when it selects, establishes, and implements trauma recovery
P6    1centers pursuant to Section 13963.1. All ITRS programs funded
2through the Safe Neighborhoods and Schools Fund shall do all of
3the following:

4(a) Provide outreach and services to crime victims who typically
5are unable to access traditional services, including, but not limited
6to, victims who are homeless, chronically mentally ill, members
7of immigrant and refugee groups, disabled, who have severe
8trauma-related symptoms or complex psychological issues, are of
9diverse ethnicity or origin, or are juvenile victims, including minors
10who have had contact with the juvenile dependency or justice
11system.

12(b) Serve victims of a wide range of crimes, including, but not
13limited to, victims of sexual assault, domestic violence, battery,
14crimes of violence, vehicular assault, human trafficking, as well
15as family members of homicide victims.

16(c) Offer a structured evidence-based program of mental health
17and support services that provide victims with services that include
18intervention, individual and group treatment, medication
19management, substance abuse treatment, case management, and
20assertive outreach. This care shall be provided in a manner that
21increases access to services and removes barriers to care for victims
22of violent crime, such as providing services to a victim in his or
23her home, in the community, or other locations that may be outside
24the agency.

25(d) Be comprised of a staff that includes a multidisciplinary
26team of integrated trauma clinicians made up of psychiatrists,
27psychologists, and social workers. A trauma clinician shall be
28either a licensed clinician or a supervised clinician engaged in
29completion of the applicable licensure process. Clinical supervision
30and other supports shall be provided to staff regularly to ensure
31the highest quality of care and to help staff constructively manage
32vicarious trauma they experience as service providers to victims
33of violent crime.

34(e) Offer psychotherapy and case management that is
35coordinated through a single point of contact for the victim, with
36support from an integrated multidisciplinary trauma treatment
37team. All treatment teams shall collaboratively develop treatment
38plans in order to achieve positive outcomes for clients.

39(f) Deliver services that include assertive case management.
40These services shall include, but are not limited to, accompanying
P7    1a client to court proceedings, medical appointments, or other
2community appointments as needed, case management services
3such as assistance in the completion and filing of an application
4for assistance to the California Victims’ Compensation Program,
5the filing of police reports, assistance with obtaining safe housing
6and financial entitlements, providing linkages to medical care,
7providing assistance securing employment, working as a liaison
8to other community agencies, law enforcement, or other supportive
9service providers as needed.

10(g) Ensure that no person is excluded from services solely on
11the basis of emotional or behavioral issues resulting from trauma,
12including, but not limited to, substance abuse problems, low-initial
13motivation, or high levels of anxiety.

14(h) Adhere to established, evidence-based practices, including,
15but not limited to, motivational interviewing, harm reduction,
16seeking safety, cognitive behavioral therapy, dialectical behavior,
17and cognitive processing therapy.

18(i) Maintain as a primary goal a decrease in psychosocial
19distress, minimize long-term disability, improve overall quality of
20life, reduce the risk of future victimization, and promote
21post-traumatic growth.

22(j) Provide holistic and accountable services that ensure
23treatment shall be provided for up to 16 sessions. For those with
24ongoing problems and a primary focus on trauma, treatment may
25be extended after special consideration with the clinical supervisor.
26Extension beyond 32 sessions shall require approval by a clinical
27steering and utilization group that considers the client’s progress
28in treatment and remaining need.

29

SEC. 4.  

Section 13963.3 is added to the Government Code, to
30read:

31

13963.3.  

(a) The board shall enter into an interagency
32agreement with the Trauma Recovery Center of the University of
33California, San Francisco, to establish the State Pilot TRC as the
34State of California’s Trauma Recovery Center of Excellence
35(TR-COE). This agreement shall require:

36(1) The TR-COE to define the core elements of the
37evidence-based practice.

38(2) The board to consult with the TR-COE in the replication of
39the integrated trauma recovery services approach.

P8    1(3) The TR-COE to assist by providing training materials,
2technical assistance, and ongoing consultation to the board and to
3each center to enable the grantees to replicate the evidence-based
4approach.

5(4) The TR-COE to assist in evaluation by designing a multisite
6evaluation to measure adherence to the practice and effectiveness
7of each center.

8(b) The board shall not spend more than 5 percent annually of
9the moneys appropriated to it from the Safe Neighborhoods and
10Schools Fund for administrative costs.

11(c) The board shall, in compliance with Section 9795, annually
12report to the Legislature on the funding received from the Safe
13Neighborhoods and Schools Fund with a detailed summary of the
14programs funded by the moneys allocated to it from said fund.

15(d) This section does not apply to the University of California
16unless the Regents of the University of California, by appropriate
17resolution, make this section applicable.

18

SEC. 5.  

Section 13963.4 is added to the Government Code, to
19read:

20

13963.4.  

(a) The board shall create an advisory committee to
21advise the board on matters pertaining to the administration of
22funds designated for use at trauma recovery centers.

23(b) The advisory committee shall have the authority to make
24recommendations to the board related to regulations governing
25funds for trauma recovery centers that are administered by the
26board.

27(c) The advisory committee shall have the authority to make
28recommendations to the board relating to the criteria for awarding
29grants to trauma recovery centers, including, but not limited to,
30any funds received from the Safe Neighborhoods and Schools
31Fund.

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

33(1) One representative from each trauma recovery center in
34California.

35(2) Three services providers who are experts in the field of
36trauma recovery services, each representing a distinct geographic
37region within the state, including at least one provider who has
38significant experience in providing services to rural communities.

39(3) Three people who have previously received or are the current
40recipients of services from a trauma recovery center.

P9    1(e) The advisory committee shallbegin delete have the authority toend delete convene
2public hearings for the purpose of acting on any of the authority
3delegated to it by this section.

4(f) All meetings of the advisory committee shall be publicly
5noticed and a record of those hearings maintained.

6(g) Nothing in this section shall prohibit, limit, or otherwise
7prevent the board from consulting with additional experts in the
8performance of the boards duties.



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