BILL NUMBER: SB 1404	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 26, 2016
	AMENDED IN SENATE  MARCH 29, 2016

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  of 2014 
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  year.
All grants awarded by the board shall be funded only  
year  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  have the authority to
 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.