BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 1404|
|Office of Senate Floor Analyses | |
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THIRD READING
Bill No: SB 1404
Author: Leno (D)
Amended: 5/31/16
Vote: 21
SENATE HEALTH COMMITTEE: 9-0, 4/6/16
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth, Wolk
SENATE PUBLIC SAFETY COMMITTEE: 7-0, 4/19/16
AYES: Hancock, Anderson, Glazer, Leno, Liu, Monning, Stone
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/27/16
AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen
SUBJECT: Victims of violent crimes: trauma recovery centers
SOURCE: Californians for Safety and Justice
DIGEST: This bill recognizes the Trauma Recovery Center at San
Francisco General Hospital as the State Pilot Trauma Recovery
Center, and requires the California Victims Compensation and
Government Claims Board to use the model developed by this
center when it awards grants to establish additional trauma
recovery centers pursuant to new funding made available from
Proposition 47.
ANALYSIS:
Existing law:
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1) Establishes the California Victim Compensation and
Government Claims Board (CVCGC Board) within the Government
Operations Agency, comprised of three members: the Secretary
of the Government Operations Agency, the State Controller,
and a Governor's appointee.
2) Requires the CVCGC Board to administer a program to evaluate
applications and award grants to trauma recovery centers
(TRCs), and states the intent of the Legislature to provide
an annual appropriation of $2 million for these grants.
3) Permits the CVCGC Board to award a grant providing for up to
a maximum of three years, and is permitted to award
consecutive grants to a TRC to prevent a lapse in funding,
but is prohibited from awarding a TRC more than one grant for
any period of time.
4) Establishes, through the passage of Proposition 47 in 2014,
the Safe Neighborhoods and Schools Act, which is intended to
ensure that prison spending is focused on violent and serious
offenses, to maximize alternatives for non-serious,
non-violent crime, and to invest the savings generated from
this Act into prevention and support programs in K-12
schools, victim services, and mental health and drug
treatment.
5) Establishes the Safe Neighborhoods and School Funds (SNS
Fund) for carrying out the purposes of Proposition 47, and
requires that by August 15 of each fiscal year, the
Controller disburse moneys deposited into the SNS Fund as
follows: 25 percent to the Department of Education to improve
outcomes for pupils by reducing truancy and supporting
students who are at risk of dropping out or are victims of
crime; 10 percent to the CVCGC Board to make grants to TRCs
to provide services to victims of crime; and, 65 percent to
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the Board of State and Community Corrections, to administer a
grant program to public agencies, as specified.
This bill:
1) Recognizes the Trauma Recovery Center at San Francisco
General Hospital as the State Pilot Trauma Recovery Center
(State Pilot TRC), and requires the CVCGC Board to 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.
2) Requires all ITRS programs funded through the SNS Fund to do
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.
Requires this care to 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
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multidisciplinary team of integrated trauma clinicians
made up of psychiatrists, psychologists, and social
workers. Requires a trauma clinician to be either a
licensed clinician or a supervised clinician engaged in
completion of the applicable licensure process, and
requires clinical supervision and other supports to be
provided to staff regularly to ensure the highest quality
of care and to help staff constructively manage vicarious
trauma they experience as 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. Requires all treatment teams to
collaboratively develop treatment plans in order to
achieve positive outcomes for clients;
f) Deliver services that include assertive case
management. Requires these services to include, but not be
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 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 quality
of life, reduce the risk of future victimization, and
promote post-traumatic growth; and,
j) Provide holistic and accountable services that ensure
treatment will be provided for up to 16 sessions. For
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those with ongoing problems and a primary focus on trauma,
permits treatment to be extended after special
consideration with the clinical supervisor. Requires
extension beyond 32 sessions to be approved by a clinical
steering and utilization group that considers the client's
progress in treatment and remaining need.
3) Requires the CVCGC Board to enter into an interagency
agreement with the Trauma Recovery Center of UCSF to
establish the State Pilot TRC as California's Trauma Recovery
Center of Excellence (TR-COE), and requires this agreement to
require:
a) The TR-COE to define the core elements of the
evidence-based practice;
b) The CVCGC Board to consult with the TR-COE in the
replication of the integrated trauma recovery services
approach;
c) The TR-COE to assist by providing training materials,
technical assistance, and ongoing consultation to the
CVCGC Board and to each center to enable the grantees to
replicate the evidence-based approach; and,
d) The TRE-COE to assist in evaluation by designing a
multisite evaluation to measure adherence to the practice
and effectiveness of each center.
4) Prohibits the CVCGC Board from spending more than 5% of the
total funds it receives from the SNS Fund on an annual basis
for administrative costs.
5) Requires the CVCGC Board to annually report to the
Legislature on the funding received from the SNS Fund with a
detailed summary of the programs funded by the moneys
allocated to it.
6) Requires the CVCGC Board to create an advisory committee to
advise it on matters pertaining to the administration of
funds designated for use at TRCs.
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7) Provides the advisory committee with the authority to make
recommendations to the CVCGC Board related to regulations
governing funds for TRCs that are administered by the CVCGC
Board, and to make recommendations on the criteria for
awarding grants to TRCs.
8) Requires the advisory committee to be composed of the
following:
a) One representative from each TRC in California;
b) Three services providers who are experts in the field
of trauma recovery services, each representing a distinct
geographic region with the state, including at least one
provider who has significant experience in providing
services to rural communities; and,
c) Three people who have previously received or are
current recipients of services from a TRC.
9) Requires the advisory committee to convene public hearings
for the purpose of acting on any of the authority delegated
to it by this bill, and requires all meetings of the advisory
committee to be publicly noticed and a record of those
hearings maintained.
10)Prohibits anything in this bill from prohibiting, limiting,
or otherwise preventing the CVCGC Board from consulting with
additional experts in the performance of its duties.
11)Eliminates a provision that restricted the CVCGC Board from
awarding a TRC more than one grant for any period of time.
12)Makes various legislative findings and declarations,
including that the TRC at San Francisco General Hospital is
an award-winning, nationally recognized program, and that by
creating the TR-COE, 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
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California will have increased access to needed services.
Comments
1)Author's statement. According to the author, 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 three 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 CVCGC Board, funds $2 million in grants
annually. The TRC treatment model was developed in 2001 to
address the multiple barriers victims face recovering from
crime. The TRC model utilizes a comprehensive, flexible
approach that integrates three modes of service: assertive
outreach, clinical case management, and evidence-based
trauma-focused therapies. The model is designed to meet the
unique needs of crime victims suffering from trauma by
utilizing a multidisciplinary staff to provide direct mental
health services and health treatment while coordinating
services with law enforcement and other social service
agencies. All of these services are housed under one roof.
Survivors of crime who received services through the TRC saw
significant increases in health and wellness. Seventy-four
percent of those served showed an improvement in mental
health, and 51% demonstrated an improvement in physical
health.
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2)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, non-serious drug and property crimes, and
requiring that the resulting savings be spent on (a) mental
health and substance abuse treatment services, (b) truancy and
dropout prevention, and (c) victim services. To carry out its
purpose, Proposition 47 established 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.
3)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.
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FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Senate Appropriations Committee:
Administrative costs: Annual costs of $925,000 (Special
Fund*/General Fund**) to the CVCGC Board to review and
evaluate TRC grant applications, facilitate advisory committee
activities, secure an evaluation contractor (potentially UC)
and submit annual reports to the Legislature. Administrative
costs payable from the SNS Fund would be limited to five
percent of the SNS Fund funds received annually.
TRC grants: Major future grant awards in the millions of
dollars (Special Fund*/General Fund**) annually provided to
TRCs meeting specified criteria, including the potential for
the issuance of multiple awards to a single TRC with
overlapping grant periods. In addition to the $2 million
annual appropriation from the Restitution Fund, the LAO has
projected annual disbursements from the SNS Fund to the CVCGC
Board in the range of $10 million to $20 million to fund TRC
grants. The Restitution Fund is structurally imbalanced. In
light of the dedicated funding source for TRCs provided by
Proposition 47 (2014), removal or reduction of the annual
appropriation from the Restitution Fund may be considered in
the future.
University of California (TR-COE) activities: To the extent
the UC resolves to enter into the agreement, significant
ongoing costs (Private/Local Fund/Federal Fund/Special Fund*)
to comply with the requirements of the agreement including but
not limited to providing training materials, ongoing
consultation to the CVCGC Board and TRCs, and designing a
multisite evaluation to measure effectiveness of TRCs. Staff
notes the use of SNS Fund funds awarded as TRC grants may not
be allowable for the aforementioned activities to the extent
the activities do not "provide services to victims of crime,"
but are considered administrative in nature.
*Restitution Fund
** Safe Neighborhoods and Schools Fund (annual transfer from the
General Fund)
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SUPPORT: (Verified 5/31/16)
Californians for Safety and Justice (source)
California Catholic Conference, Inc.
California Department of Justice
Crime Victims United of California
Fathers & Families of San Joaquin
University of California
University of California Berkeley, School of Social Welfare
Society for Social Work Leadership in Health Care California
Chapter
San Francisco Department of Public Health
Three individuals
OPPOSITION: (Verified5/31/16)
None received
ARGUMENTS IN SUPPORT: This bill is sponsored by Californians
for Safety and Justice (CSJ), which states that it will help
provide quality trauma recovery services to crime victims across
the state. According to CSJ, in order to ensure that other TRCs
have the same outstanding outcomes as the San Francisco TRC,
specific programmatic guidelines must be put in place. CSJ
states that this bill does exactly that, and additionally
creates a Center of Excellence at the original TRC, to provide
training, technical assistance, and ongoing standardized program
evaluations to ensure program fidelity. Fathers & Families of
San Joaquin also supports this bill, stating that the TRC model
is one of the state's most powerful, practical and innovative
public responses to interpersonal violence, and that given the
effectiveness of this model, strongly supports this bill.
Prepared by:Vince Marchand / HEALTH / (916) 651-4111
5/31/16 20:58:26
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