BILL ANALYSIS Ó
SENATE COMMITTEE ON PUBLIC SAFETY
Senator Loni Hancock, Chair
2015 - 2016 Regular
Bill No: SB 1404 Hearing Date: April 19, 2016
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|Author: |Leno |
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|Version: |March 29, 2016 |
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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 518 (Leno) 2015, Held in Assembly
Appropriations
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: Crime Victims United of California; Fathers & Families
of San Joaquin; Natividad Medical Center; Two
individuals
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Opposition:None known
PURPOSE
The purpose of this bill is to 1) 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 )
require a TRC receiving a grant to meet specified statutory
requirements and standards; 3) establish the UCSF TRC as the
California Trauma Recovery Center of Excellence (TRC COE); 4)
require the board to complete an interagency agreement with TRC
COE in establishing core elements of an evidence-based TRC; and
5) specify procedures and policies for using funds designated
for TRC programs from the Safe Schools and Neighborhoods Fund
created through Proposition 47 in 2014.
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:
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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:
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
California voters approved Proposition 47 - the Safe
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Neighborhoods and Schools Act of 2014 - to ensure that law
enforcement resources are focused on violent crime and to
invest savings from reduced penalties for drug possession
and low-level theft crimes into prevention and support
programs through the Safe Neighborhoods and Schools Fund.
Proposition 47 requires that 10% of the Safe
Neighborhoods and Schools Funds be allocated to the Victims
Compensation Program to fund trauma recovery centers
modeled on the UCSF TRC.
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
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
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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.
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.
RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION
For the past several years this Committee has scrutinized
legislation referred to its jurisdiction for any potential
impact on prison overcrowding. Mindful of the United States
Supreme Court ruling and federal court orders relating to the
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state's ability to provide a constitutional level of health care
to its inmate population and the related issue of prison
overcrowding, this Committee has applied its "ROCA" policy as a
content-neutral, provisional measure necessary to ensure that
the Legislature does not erode progress in reducing prison
overcrowding.
On February 10, 2014, the federal court ordered California to
reduce its in-state adult institution population to 137.5% of
design capacity by February 28, 2016, as follows:
143% of design bed capacity by June 30, 2014;
141.5% of design bed capacity by February 28, 2015; and,
137.5% of design bed capacity by February 28, 2016.
In December of 2015 the administration reported that as "of
December 9, 2015, 112,510 inmates were housed in the State's 34
adult institutions, which amounts to 136.0% of design bed
capacity, and 5,264 inmates were housed in out-of-state
facilities. The current population is 1,212 inmates below the
final court-ordered population benchmark of 137.5% of design bed
capacity, and has been under that benchmark since February
2015." (Defendants' December 2015 Status Report in Response to
February 10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge
Court, Coleman v. Brown, Plata v. Brown (fn. omitted).) One
year ago, 115,826 inmates were housed in the State's 34 adult
institutions, which amounted to 140.0% of design bed capacity,
and 8,864 inmates were housed in out-of-state facilities.
(Defendants' December 2014 Status Report in Response to February
10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge Court, Coleman
v. Brown, Plata v. Brown (fn. omitted).)
While significant gains have been made in reducing the prison
population, the state must stabilize these advances and
demonstrate to the federal court that California has in place
the "durable solution" to prison overcrowding "consistently
demanded" by the court. (Opinion Re: Order Granting in Part and
Denying in Part Defendants' Request For Extension of December
31, 2013 Deadline, NO. 2:90-cv-0520 LKK DAD (PC), 3-Judge Court,
Coleman v. Brown, Plata v. Brown (2-10-14). The Committee's
consideration of bills that may impact the prison population
therefore will be informed by the following questions:
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Whether a proposal erodes a measure which has contributed
to reducing the prison population;
Whether a proposal addresses a major area of public safety
or criminal activity for which there is no other
reasonable, appropriate remedy;
Whether a proposal addresses a crime which is directly
dangerous to the physical safety of others for which there
is no other reasonably appropriate sanction;
Whether a proposal corrects a constitutional problem or
legislative drafting error; and
Whether a proposal proposes penalties which are
proportionate, and cannot be achieved through any other
reasonably appropriate remedy.
COMMENTS
1. Need for This Bill
According to the author:
Senate Bill 1404 will create clear guidelines for
the provision of Trauma Recovery Center (TRC)
services administered by the Victims Compensation
& Government Claims Board (VCGCB) in California, as
well as bolster training and technical assistance to
new centers. 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
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
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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 under 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.
SB 1404 creates clear guidelines for the provision
of TRC services administered by the Victims
Compensation & Government Claims Board (VCGCB) in
California. By setting clear guidelines and
bolstering training for new trauma recovery centers,
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. This bill will 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.
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The physical and psychological trauma experienced by
victims of crime requires early treatment and
comprehensive care in order to avoid negative outcomes
for the individual victim, as well as their families
and communities. 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.
Victims must navigate an often difficult and
bureaucratic process in accessing state services,
involving multiple agencies across different
locations. If a victim is ultimately approved for
state support, they may wait 3 months or more to
access victim's compensation funds to help cover the
costs of critical support services. Without timely
holistic support, victims often suffer long term
mental health challenges and struggle to take care of
their families, maintain employment and retain stable
housing. Free, holistic care that is easy to access
would be life changing for many.
In order to address this pressing need, a grant
program to replicate a successful TRC in San Francisco
was created in 2013. This program, housed at the
VCGCB, funds $2 million in grants annually.
2.History of the TRC at San Francisco General Hospital
The TRC at San Francisco General Hospital was originally
established pursuant to legislation passed in 2000. AB 2491
(Jackson, Chapter 1016, Statutes of 2000), among other
provisions, required the CVCGC Board to enter into an
interagency agreement with the University of California, San
Francisco, to establish a victims of crime recovery center at
San Francisco General Hospital as a four year pilot project to
demonstrate the effectiveness of providing comprehensive and
integrated services to victims of crime, as an alternative to
fee-for-service care reimbursed by the Victim Restitution funds.
The goals of the TRC included improving the process of care for
victims of crime by enhancing medical services for acute victims
of sexual assault, linking victims to other services to
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facilitate recovery, and improving access to victim compensation
funds. In May 2004, the CVCGC Board published its required
report to the Legislature on the effectiveness of the victims of
crime recovery center, and concluded that the TRC model provides
a wider, more effective, range of services at a lower cost for
trauma victims that the traditional fee-for-service mental
health treatment programs. According to the report, the data
demonstrated that this model of care is effective in engaging
victims of crime with needed services, improving cooperation
with law enforcement, reducing homelessness, facilitating return
to work, reducing alcohol and drug abuse, and improving quality
of life among victims of interpersonal violence.
3.Expansion of TRC Model to Other Areas of State
SB 7 (Budget and Fiscal Review, Chapter 28, Statutes of 2013)
created a $2 million grant program within the CVCGC Board to
expand the TRC concept to additional areas of the state. With
this funding, in October of 2014 the CVCGC Board awarded grants
to two TRCs: $670,000 to the Downtown Women's Center in Los
Angeles, and $1.3 million to the California State University at
Long Beach. In May of 2015, three grants were awarded: $426,341
to the Children's Nurturing Project in Fairfield, which partners
with LIFT3 Support Group to provide a comprehensive system of
care focused on domestic violence survivors; $716,932 to Fathers
and Families of San Joaquin, located in Stockton, partnering
with the San Joaquin Behavioral Health Services to provide
comprehensive mental health and recovery services to victims of
crime; and, $856,727 to the Special Service for Groups, which
partners with the Homeless Outreach Program Integrated Care
System to provide mental health services to underserved crime
victims in south Los Angeles.
4. Proposition 47
On November 4, 2014, voters approved Proposition 47, titled the
Safe Neighborhoods and Schools Act, which was placed on the
ballot as a citizen's initiative. Proposition 47 made
significant changes to the state's criminal justice system by
reducing penalties for certain non-violent, nonserious drug and
property crimes, and requiring that the resulting savings be
spent on (1) mental health and substance abuse treatment
services, (2) truancy and dropout prevention, and (3) victim
services. To carry out its purpose, Proposition 47 established
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the SNS Fund, and required that by August 15 of each fiscal
year, the Controller disburse moneys deposited into the SNS Fund
as follows: 25% to the Department of Education to improve
outcomes for pupils by reducing truancy and supporting students
who are risk of dropping out or are victims of crime; 10% to the
CVCGC Board to make grants to TRCs to provide services to
victims of crime; and, 65% to the Board of State and Community
Corrections, to administer a grant program to public agencies,
as specified.
5. Legislative Analyst's Report
In March of 2015, the Legislative Analyst's Office released a
report "Improving State Programs for Crime Victims" (LAO
report). According to the LAO report, if appropriated
structured, TRCs can provide a wide array of services to victims
at a single location and can complement existing victim
programs. The LAO recommended that the Legislature structure the
TRC grants to ensure the funds are spent in an effective and
efficient manner and to require the evaluation of TRC grant
recipients and their outcomes. The LAO also recommended that the
Legislature adopt statutory changes to allow TRCs to have
formally recognized victim advocates, which would allow TRCs to
have trained staff that can represent victims in their
application for victim compensation funds, which would likely
increase the approval rate. The LAO also recommended
prioritizing TRC grants to regions that do not have a TRC,
noting that there are many victims who do not have access to a
TRC because they do not live in Los Angeles or San Francisco.
6. Research about Victim Recovery and the Community-Wide Harm
Caused by Crime
The concerns of victims have become increasingly recognized over
the past decades. 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
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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
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.
7. Author's Amendments from Health Committee Hearing
---------------------------
<1> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684449/
<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
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At the suggestion of Senate Health Committee, the author
proposes that the bill be amended at the hearing in this
committee to do the following:
Existing law (reflected on Page 4, lines 24-27) states the
intent of the Legislature to provide an annual appropriation of
$2 million, and requires all grants awarded by the CVCGC Board
to be funded only from the Restitution Fund. However, now the
Proposition 47 will be directing funds to TRCs from the SNS
Fund, the bill should be amended to clarify that the $2 million
annual appropriation is from the Restitution Fund, and to delete
the limitation that grants only be awarded from this fund, in
order to allow for grants funded by the SNS Fund.
On Page 9, lines 12-13, this bill requires the newly created
advisory committee to the CVCGC Board to "have the authority to
convene public hearings" for the purpose of acting on any of its
delegated authority. This provision should be clarified to
actually require the advisory committee to convene public
hearings, rather than just having the authority to do so.
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