BILL NUMBER: SB 1404AMENDED BILL TEXT AMENDED IN ASSEMBLY AUGUST 1, 2016 AMENDED IN SENATE MAY 31, 2016 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, 13963.2 and 13963.3 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 technical assistance provider to the board for the period between July 1, 2017, and June 30, 2019. The bill would require the board to select a trauma recovery center, through a competitive process, to be the technical assistance provider every 2 years thereafter and would require that provider to assist the board by 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. The bill would authorize the board to provide grants, upon appropriation by the Legislature, to the technical assistance provider, up to a specified amount. The bill would require the board, through a competitive process, to select a 3rd party evaluator to conduct a review of the effectiveness of the trauma resource center model and the work done by grant recipients with the trauma resource center funds. 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 and Government Claims Board to make grants to trauma recovery centers to provide services to victims of crime. (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, providing assistance to the board in administering grants to trauma recovery centers, 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 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. Psychiatrists on this team may be on staff or on contract. 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: TRC as the technical assistance provider to the board for the period between July 1, 2017, and June 30, 2019. After June 30, 2019, and every two years thereafter, the board shall select a technical assistance provider through a competitive grant process. The technical assistance provider shall be a trauma recovery center that meets the requirements in subdivision (b) of Section 13963.1. (1) The TR-COE to define the core elements of the evidence-based practice. (b) The technical assistance provider shall receive a grant of no more than five hundred thousand dollars ($500,000) per year from funds appropriated by the Legislature from the Restitution Fund pursuant to subdivision (c) of Section 13963.1. (c) The technical assistance provider shall do all of the following: (2) The board to consult with the TR-COE (1) Consult with the board to assist the board in the replication of the integrated trauma recovery services approach. (3) The TR-COE to assist (2) Assist the board 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) (d) (1) The board shall not spend more than 5 percent of the total funds it receives from the Safe Neighborhoods and Schools Fund on an annual basis for administrative costs. (2) (A) From the funds received from the Safe Neighborhoods and Schools Fund and used for administrative costs, the board shall, through a competitive process and for a period not to exceed three years, select and provide a grant for a third-party evaluator to conduct a review of the effectiveness of the trauma resource center model and the work done by grant recipients with trauma resource center funds. (B) The evaluator shall consult with the technical assistance provider in its design of its evaluation. (c) (e) 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) (f) 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 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.