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 Californias 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.

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 Californias 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.

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 Californias 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.

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, 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 Californias 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.

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 Californias 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.

Date of Hearing: August 3, 2016

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

SBPCA Bill Id:SB 1404

Author:(Leno) – As Amended Ver:August 1, 2016

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill requires the Victims Compensation Board (VCB) to use a specified evidence-based Integrated Trauma Recovery Services (ITRS) model, developed by the Trauma Recovery Center (TRC) at the San Francisco General Hospital, University of California San Francisco (UCSF), (recognized as the State Pilot TRC) when giving a grant to a TRC. This bill also specifies core elements that the ITRS model must include.

FISCAL EFFECT:

1. Annual costs of $145,000 (Special Fund/General Fund) to VCB to review and evaluate TRC grant applications, 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 Funds received annually, the difference will be a General Fund pressure.
   
2. The additional core elements required to be met by new TRCs could result in costs pressures in the hundreds of thousands of dollars to the Victim Restitution Fund (VRF) and Proposition 47 funds by requiring a higher level of service of TRC grantees.
3. Earmarks up to $500,000 per year (from the existing Restitution Fund appropriation), for a technical assistance provider (UC the first two years) to provide training materials and ongoing consultation to the VCB and TRCs to enable grantees to replicate the evidence-based approach.
4. The 2016-17 Budget includes approximately $4 million in Proposition 47 funds and $2 million from the Restitution Fund, of which approximately $5.5 million will be available for TRCs.

COMMENTS:

1. Purpose. According to the author, this bill creates clear guidelines for the provision of TRC services administered by the VCB, and that 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.
2. Background. Current law requires the VCB 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.

TRCs directly assist victims in coping with a traumatic event (such as by providing mental health care and substance use treatment). For example, victims may receive weekly counseling sessions with a licensed mental health professional at a TRC for a specified amount of time. The centers also sometimes help victims connect with other services provided in their community and by the state. While some of the TRCs existed before receiving grants from VCB, the board first began funding TRCs in 2001 with a grant to the San Francisco TRC. Since then, three other TRCs have also received state funding—one in Long Beach and two in Los Angeles. For 2016-17, VCB will provide approximately $4.5 million to six TRCs located in San Francisco, Long Beach, San Joaquin and Solano Counties, and two in Los Angeles.

1. Proposition 47 (2014). Current law establishes the SNS Fund for carrying out the purposes of Proposition 47 (the Safe Neighborhoods and Schools Act), and requires that by August 15 of each fiscal year, the State 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 at risk of dropping out or are victims of crime; 10% to the VCB 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.
2. Support. Californians for Safety and Justice (CFSJ) are the sponsors of this bill and state, “the TRC model, pioneered in San Francisco in 2001, provides a comprehensive, flexible approach that integrates three modes of service: assertive outreach, clinical case management, and evidence-based trauma-focused therapies.”

Analysis Prepared by: Pedro R. Reyes / APPR. / (916) 319-2081

Date of Hearing: June 28, 2016

ASSEMBLY COMMITTEE ON HEALTH

Jim Wood, Chair

SBPCA Bill Id:SB 1404

Author:(Leno) – As Amended Ver:May 31, 2016

SENATE VOTE: 39-0

SUBJECT: Victims of violent crimes: trauma recovery centers.

SUMMARY: Recognizes the Trauma Recovery Center at San Francisco General Hospital, University of California, San Francisco (UCSF TRC) as the State Pilot Trauma Recovery Center (State Pilot TRC), and requires the California Victims Compensation and Government Claims Board (CVCGC Board) to use the model developed by the State Pilot TRC when it establishes additional trauma recovery centers. Specifically, this bill:

1. Recognizes the UCSF TRC as the State Pilot TRC, and requires the CVCGC Board to use the 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 Safe Neighborhoods and Schools Fund (SNS Fund) to do all of the following:
   1. 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;
   2. 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;
   3. 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;
   4. Be comprised of a staff that includes a 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;
   5. 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;
      
   6. 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;
      
   7. 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;
      
   8. 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;
      
   9. 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,
      
   10. Provide holistic and accountable services that ensure treatment will be provided for up to 16 sessions. For 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:
   
   1. The TR-COE to define the core elements of the evidence-based practice;
      
   2. The CVCGC 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 CVCGC Board and to each center to enable the grantees to replicate the evidence-based approach; and,
      
   4. The TRE-COE to assist in evaluation by designing a multisite evaluation to measure adherence to the practice and effectiveness of each center.

1. 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.
2. 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.
   
3. Specifies that these provisions do not apply to the University of California unless the Regents pass resolution agreeing to do so.
   
4. 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.
   
5. 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.
   
6. Requires the advisory committee to be composed of the following:
   
   1. One representative from each TRC in California;
      
   2. 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,
      
   3. Three people who have previously received or are current recipients of services from a TRC.
      
7. 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.
   
8. 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.
   
9. Eliminates a provision that restricted the CVCGC Board from awarding a TRC more than one grant for any period of time.
   
10. 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 California will have increased access to needed services.
    
    
    
    

EXISTING LAW:

1. Establishes the 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 Fund (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% 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% 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.

FISCAL EFFECT: According to the Senate Appropriations Committee:

1. 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.
   
2. 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.
3. 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)

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, this bill creates clear guidelines for the provision of TRC services administered by the CVCGC Board, and that 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. The author states that survivors of crime who received services through the TRC saw significant increases in health and wellness, for example 74% of those served showed an improvement in mental health, and 51% demonstrated an improvement in physical health. The author contends that TRC services have also improved community engagement and public safety, pointing out that 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.
   
2. BACKGROUND.
   1. TRCs. TRCs are centers that directly assist victims in coping with a traumatic event (such as by providing mental health care and substance use treatment). For example, victims may receive weekly counseling sessions with a licensed mental health professional at a TRC for a specified amount of time. The centers also sometimes help victims connect with other services provided in their community and by the state. While some of the TRCs existed before receiving grants from CVCGC Board, the board first began funding TRCs in 2001 with a grant to the San Francisco TRC. Since then, three other TRCs have also received state funding—one in Long Beach and two in Los Angeles. Currently, CVCGC Board provides a total of $2 million annually in grants to four TRCs located in San Francisco, Long Beach, and two in Los Angeles.
   2. 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 appropriately 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.

Beginning in 2016–17, funding for TRCs will increase significantly as a result of Proposition 47, passed by voters in November 2014. Proposition 47 reduces the penalties for certain crimes, which will result in state savings, mainly by reducing the number of inmates in state prisons. Under the measure, these savings will be deposited into a special fund with 10% of the funds provided to CVCGC Board for TRCs. The LAO estimates that Proposition 47 funding for TRCs will likely total between $10 million and $20 million annually beginning in 2016–17. This would reflect an increase in funding for TRCs of roughly five to ten times the current level.

1. SUPPORT. Californians for Safety and Justice (CFSJ) are the sponsors of this bill and state, the TRC model, pioneered in San Francisco in 2001, provides a comprehensive, flexible approach that integrates three modes of service: assertive outreach, clinical case management, and evidence-based trauma-focused therapies. CFSJ notes that this model is designed to meet the special 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 under one roof. CFSJ concludes that survivors of crime who received services through the TRC saw huge increases in health and wellness.
   
   The California Catholic Conference, Inc. (CCC) supports this bill and notes that victims must navigate an often difficult and bureaucratic process in accessing state services, involving multiple agencies across different locations. CCC states that if a victim is ultimately approved for state support, they may wait three months or more to access funds to help cover the costs of critical services. CCC notes the TRC treatment model was developed in 2001 to address multiple barriers victims face recovering from crime, and in order to ensure these same outstanding outcomes and savings, and to ensure fidelity to the TRC model, clear guidelines must be added to the statute governing the grant program.
2. PREVIOUS LEGISLATION.
   1. SB 518 (Leno), of 2015 would have required the CVCGC Board to use a specified evidence-based model when giving a grant to a TRC, as specified. SB 518 was held in the Assembly Appropriations Committee.
   2. SB 71 (Committee on Budget and Fiscal Review), Chapter 28, Statutes of 2013, authorized the CVCGC Board to administer a program to award, upon appropriation by the Legislature, up to $2,000,000 in grants, annually, to TRCs, as defined, funded from the Restitution Fund.
      
   3. SB 733 (Leno), of the 2009-10 legislative session, would have authorized the CVCGC Board to evaluate applications and award grants totaling up to $3 million, up to $1.7 million per center, to multi-disciplinary TRCs that provide specified services to and resources for crime victims. SB 733 failed passage on the Senate Floor.
      
   4. AB 1669 (Leno), of the 2007-08 Legislative Session, would have appropriated $1.5 million for the TRC at the San Francisco General Hospital. AB 1669 was vetoed.
   5. AB 50 (Leno), Chapter 884, Statutes of 2006, appropriated $1.3 million for the TRC at the San Francisco General Hospital.

REGISTERED SUPPORT / OPPOSITION:

Support

Californians for Safety and Justice (sponsor)
Kamala D. Harris, Attorney General, State of California
California Catholic Conference, Inc.
Crime Victims United of California
Fathers & Families of San Joaquin

Natividad Medical Center
San Francisco Department of Public Health

Society for Social Work Leadership in Health Care, California Chapter
University of California

One individual

Opposition

None on file.

Analysis Prepared by: Lara Flynn / HEALTH / (916) 319-2097

Date of Hearing: June 21, 2016

Counsel: Gabriel Caswell

ASSEMBLY COMMITTEE ON PUBLIC SAFETY

Reginald Byron Jones-Sawyer, Sr., Chair

SBPCA Bill Id:SB 1404

Author:(Leno) – As Amended Ver:May 31, 2016

SUMMARY: 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. Specifically, this bill:

1. Provides that 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. In replicating programs funded by the California Victim Compensation and Government Claims Board, the ITRS can be modified to adapt to different populations, but it shall include the following core elements:
   1. 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, 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, and vehicular assault, human trafficking, and family members of homicide victims.
   3. A structured evidence-based program of mental health and support services provided to victims of violent crimes or family members of homicide victims that includes crisis 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. This includes providing services in the client’s home, in the community, or other locations outside the agency.
   4. Staff shall include a multidisciplinary team of integrated trauma specialists that includes psychiatrists, psychologists, and social workers. The integrated trauma specialist shall be a licensed clinician, or a supervised clinician engaged in completion of the applicable licensure process. Clinical supervision and other supports are provided to staff on a weekly basis to ensure the highest quality of care and to help staff deal constructively with vicarious trauma.
   5. Psychotherapy and case management shall be provided by a single point of contact for the client, that is an individual trauma specialist, with support from an integrated trauma treatment team. In order to ensure the highest quality of care, the treatment team shall collaboratively develop treatment plans in order to achieve positive outcomes for clients.
   6. Services shall include assertive case management, including, but not limited to, a trauma specialist accompanying the client to court proceedings, medical appointments, or other community appointments as needed. Case management services shall include, but not be limited to, assisting clients file victim compensation applications, file police reports, help with obtaining safe housing and financial entitlements, linkages with medical care, assistance in return to work, liaison with other community agencies, law enforcement, and other support services as needed.
   7. Clients shall not be 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.
   8. Trauma recovery services shall incorporate established evidence-based practices, including, but not limited to, motivational interviewing, harm reduction, seeking safety, cognitive behavioral therapy, dialectical behavior, and cognitive processing therapy.
   9. The goals of a trauma recovery center shall be to decrease psychosocial distress, minimize long-term disability, improve overall quality of life, reduce the risk of future victimization, and promote post-traumatic growth.
   10. In order to ensure that clients are receiving targeted and accountable services, treatment shall be provided 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.
2. Finds and declares the following:
   1. 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.
   2. 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.
      
   3. 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.
      
   4. The Legislature further finds and declares that 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, and clinically effective and cost effective.

EXISTING LAW:

1. Creates the Victims of Crime Program, administered by the Board , 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.)
   
2. Authorizes reimbursement to a victim for "[t]he medical or medical related expenses incurred by the victim." (Gov. Code, § 13957, subd. (a)(1).)
   
3. Provides that the Board 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.)
   
4. Includes the Safe Neighborhoods and Schools Act of 2014. As relevant to this bill, the act does the following: (Gov. Code, § 7599-7599.2.)
   
   1. 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.
      
   2. Requires the Director of Finance, beginning in 2016, to calculate the savings from the reduced penalties.
      
   3. 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.
      
   4. The Controller then distributes the money in the fund according to the following formula:
      
      1. 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.
         
      2. 10% to the Victims of Crime Program to fund for grants to TRCs.
         
      3. 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.
         

FISCAL EFFECT: Unknown.

COMMENTS:

1. Author's Statement: According to the author, "SB 1404 creates clear guidelines for the provision of Trauma Recovery Center (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. 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. TRC services have also improved community engagement and public safety. 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."
2. Background: According to the background provided by the author, Senate Bill 1404 creates 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 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.

1. 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 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.
2. 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.
3. Proposition 47 and Trauma Recovery Center Funding: 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 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.

According to the California Secretary of State's Web site, 59.6 % of voters approved Proposition 47. (See <http://elections.cdn.sos.ca.gov/sov/2014-general/pdf/2014-complete-sov.pdf> [as of Mar. 14, 2015].) The purpose of the measure was "to maximize alternatives for nonserious, nonviolent 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." (Ballot Pamp., Gen. Elec. (Nov. 4, 2014), Text of Proposed Laws, p. 70.) One of the ways the measure created savings was by requiring misdemeanor penalties instead of felonies for nonserious, nonviolent crimes like petty theft and drug possession for personal use, unless the defendant has prior convictions for specified violent crimes. (Ibid.)

Four months into its implementation, Proposition 47 has resulted in fewer inmates in state prisons and county jails. According to the Legislative Analysts' Office (LAO), "As of January 28, 2015, the inmate population in the state's prisons was about 113,500, or 3,600

inmates below the February 2015 cap, and slightly below the final February 2016 cap. The expected impact of Proposition 47 on the prison population will make it easier for the state to remain below the population cap." (LAO, The 2015-16 Budget: Implementation of Proposition 47 (Feb. 2015), p. 10.) The LAO report also found that Proposition 47 will likely reduce the costs of criminal justice for counties, by freeing up jail beds and reducing the time probation departments need to follow prisoners after they are released. (Id. at p. 17.)

1. 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.
2. Argument in Support: According to Californians for Safety and Justice, "We are pleased to sponsor Senate Bill 1404, which would create programmatic guidelines for the Trauma Recovery Center (TRC) Grant Program and create the TRC Center of Excellence, housed at UC San Francisco, to provide systematic training, technical assistance and ongoing standardized program evaluations to ensure program fidelity. This bill would help provide quality trauma recovery services to crime victims across the state.

"Californians for Safety and Justice is a nonprofit organization of Californians from diverse sectors joining together to replace prison and justice system waste with smart justice solutions that increase safety and reduce costs. Our work includes a statewide network of over 5,000 crime victims, Crime Survivors for Safety and Justice, a group that aims to reduce barriers to recovery for crime victims and expand victims' support.

"The Trauma Recovery Center model, pioneered in San Francisco in 2001, provides a comprehensive, flexible approach that integrates three modes of service – assertive outreach, clinical case management, and evidence-based trauma-focused therapies. This model is designed to meet the special 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 under one roof. Survivors of crime who received services through the TRC saw huge increases in health and wellness – 74% show an improvement in mental health, and 51% demonstrate an improvement in physical health. TRC services also improved community engagement and public safety. People who receive services at the TRC are 56% more likely to return to employment, and people who receive services are 44% more likely to cooperate with the district attorney, and 69% more likely to cooperate with law enforcement.

"In 2013, a grant program was created to replicate this successful TRC model in other parts of California. This program, housed at the Victim Compensation and Government Claims Board (VCGCB), totals $2 million annually. In order to ensure other TRCs have the same outstanding outcomes as the San Francisco TRC, specific programmatic guidelines must be in place. SB 518 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."

1. Prior Legislation:
   1. SB 518 (Leno), Required the Victims Compensation and Government Claims Board (Board) to use a specified evidence-based model when giving a grant to a Trauma Recovery Center (TRC), as specified. SB 518 was held in the Assembly Appropriations Committee.
   2. SB 71 (Budget and Fiscal Review), Chapter 28, Statutes of 2013, authorized the Board to administer a program to award, upon appropriation by the Legislature, up to $2,000,000 in grants, annually, to trauma recovery centers, as defined, funded from the Restitution Fund.
   3. SB 733 (Leno), of the 2009-2010 legislative session, authorized the Board to evaluate applications and award grants totaling up to $3 million, up to $1.7 million per center, to multi-disciplinary TRCs that provide specified services to and resources for crime victims. SB 733 failed passage on the Senate Floor.
   4. AB 1669 (Leno), of the 2007-08 Legislative Session, would have appropriated $1.5 million for the TRC at the San Francisco General Hospital. AB 1669 was vetoed.
      
   5. AB 50 (Leno), Chapter 884, Statutes of 2006, appropriated $1.3 million for the TRC at the San Francisco General Hospital.

REGISTERED SUPPORT / OPPOSITION:

Support

Californians for Safety and Justice (sponsor)

Association of Deputy District Attorneys

Association for Los Angeles Deputy Sheriffs

California Association of Code Enforcement Officers

California Attorney General's Office

California Catholic Conference

California College and University Police Chiefs Association

California Narcotic Officers Association

Children's Defense Fund

Crime Victims United

Fathers and Families of San Joaquin

Los Angeles County Professional Peace Officers Association

Los Angeles Policy Protective League

Natividad Medical Center

Riverside Sheriffs Association

San Francisco Department of Public Health

Society for Social Work Leadership in Health Care, California Chapter

University of California

University of California at Berkeley School of Social Welfare

Opposition

None

Analysis Prepared by: Gabriel Caswell / PUB. S. / (916) 319-3744

 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:

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 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:
   1. 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;
   2. 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;
   3. 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;
   4. Be comprised of a staff that includes a 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;
   5. 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;
   6. 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;
   7. 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;
   8. 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;
   9. 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,
   10. Provide holistic and accountable services that ensure treatment will be provided for up to 16 sessions. For 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:
   1. The TR-COE to define the core elements of the evidence-based practice;
   2. The CVCGC 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 CVCGC Board and to each center to enable the grantees to replicate the evidence-based approach; and,
   4. 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.
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:
   1. One representative from each TRC in California;
   2. 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,
   3. 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 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.
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.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: 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)

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: (Verified 5/31/16)

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

**** END ***

SENATE COMMITTEE ON

Senator Ricardo Lara, Chair

2015 - 2016 Regular Session

SB 1404 (Leno) - Victims of violent crimes: trauma recovery centers

Bill Summary:

SB 1404 would recognize the University of California, San Francisco General Hospital Trauma Recovery Center (UCSF TRC) as the State Pilot TRC, and would require the Victim Compensation and Government Claims Board (Board) to enter into an interagency agreement with the UCSF TRC to establish the State Pilot TRC as the state’s trauma recovery center of excellence (TR-COE), as specified. This bill:

• Removes the restriction in existing law limiting TRC grant funding only from the Restitution Fund.
• Deletes the limitation in existing law restricting the number of grant awards to a specific TRC to no more than one grant for any period of time.
• Requires TRCs funded through the Safe Neighborhoods and Schools Fund (SNSF) to meet specified statutory requirements and standards.
• Specifies procedures and policies, including reporting requirements, for using funds from the SNSF created through Proposition 47 (2014).
• Requires the Board to create an advisory committee to make recommendations on regulations governing TRC funding and the criteria for awarding grants.

*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********

The following information is revised to reflect amendments

adopted by the committee on May 27, 2016

Fiscal Impact:

• Administrative costs: Annual costs of $925,000 (Special Fund*/General Fund**) to the 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 SNSF would be limited to 5 percent of the SNSF 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 SNSF to the 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.
• UC (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 Board and TRCs, and designing a multisite evaluation to measure effectiveness of TRCs. Staff notes the use of SNSF 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)

Author Amendments:

Make the following technical changes:

1. On page 3, lines 21-23:

(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 and Government Claims Board to administer a grant program to establish make grants to trauma recovery centers to provide services to victims of crime modeled after the UCSF TRC.

1. On page 8, lines 8-10:

(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. of the total funds it receives from the Safe Neighborhoods and Schools Fund on an annual basis for administrative costs.

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SENATE COMMITTEE ON APPROPRIATIONS

Senator Ricardo Lara, Chair

2015 - 2016 Regular Session

SB 1404 (Leno) - Victims of violent crimes: trauma recovery centers

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

SB 1404 would recognize the University of California, San Francisco General Hospital Trauma Recovery Center (UCSF TRC) as the State Pilot TRC, and would require the Victim Compensation and Government Claims Board (Board) to enter into an interagency agreement with the UCSF TRC to establish the State Pilot TRC as the state’s trauma recovery center of excellence (TR-COE), as specified. This bill:

• Removes the restriction in existing law limiting TRC grant funding only from the Restitution Fund.
• Deletes the limitation in existing law restricting the number of grant awards to a specific TRC to no more than one grant for any period of time.
• Requires TRCs funded through the Safe Neighborhoods and Schools Fund (SNSF) to meet specified statutory requirements and standards.
• Specifies procedures and policies, including reporting requirements, for using funds from the SNSF created through Proposition 47 (2014).
• Requires the Board to create an advisory committee to make recommendations on regulations governing TRC funding and the criteria for awarding grants.

Fiscal Impact:

• Administrative costs: Annual costs of $925,000 (Special Fund*/General Fund**) to the 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 SNSF would be limited to 5 percent of the SNSF 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 SNSF to the 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.
• UC (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 Board and TRCs, and designing a multisite evaluation to measure effectiveness of TRCs. Staff notes the use of SNSF 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)

Background:

Existing law creates the Victims of Crime Program, administered by the California Victim Compensation and Government Claims Board (Board), to reimburse victims of crime for the pecuniary losses they suffer as a direct result of criminal acts such as medical related expenses. Indemnification is made from the Restitution Fund, which is continuously appropriated to the Board for these purposes.

Existing law requires the Board to 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 funding appropriated for that purpose. (Government Code (GC) § 13974.5.)

Existing law provides for $2 million annually from the Restitution Fund to a grant program created in 2013 to replicate the successful TRC pioneered by UCSF. 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 co-located with one coordinating point of contact for the victim. (GC § 13963.1.)

Proposition 47, the Safe Neighborhoods and Schools Act of 2014 (Act), reclassifies controlled substance felony and alternate felony-misdemeanor crimes as misdemeanors, with exceptions for defendants convicted of a sex offense, a specified drug crime involving specified weights 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.

The Act requires the Director of Finance (DOF), by August 15 of each fiscal year beginning in 2016, to calculate the savings from the reduced penalties and requires the Controller to distribute the amount of savings according to the following formula:

• 25 percent 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 who are crime victims.
• 10 percent to the Board, to make grants to TRCs to provide services to victims of crime pursuant to Section 13963.1 of the Government Code.
• 65 percent 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. (GC §§ 7599-7599.2.)

Existing law provides that the agency responsible for administering the programs noted above shall not spend more than 5 percent of the total funds it receives from the Safe Neighborhoods and Schools Fund (SNSF) on an annual basis for administrative costs.

Existing law requires the Controller to transfer from the General Fund to the SNSF the total amount of savings calculated by the DOF. Moneys in the SNSF are continuously appropriated for the purposes of the Act. Notably, the funds transferred to the SNSF are to be used exclusively for the purposes specified in the Act and are not subject to appropriation or transfer by the Legislature for any other purpose. The funds in the SNSF may additionally be used without regard to fiscal year.

Proposed Law:

This bill would recognize the UCSF TRC as the State Pilot TRC, and would require the Board to enter into an interagency agreement with the UCSF TRC, provided that the UC agrees to the bill’s provisions through a resolution, to establish the State Pilot TRC as the state’s trauma recovery center of excellence, as specified. Additionally, this bill:

• Requires the Board to use the evidence-based Integrated Trauma Recovery Services (ITRS) model developed by the State Pilot TRC when selecting, establishing, and implementing TRCs, as specified.
• Removes the prohibition in existing law limiting TRC grant funding only from the Restitution Fund.
• Deletes the limitation in existing law restricting the number of grant awards to a specific TRC to no more than one grant for any period of time.
• Requires TRCs funded through the Safe Neighborhoods and Schools Fund (SNSF) to meet numerous specified statutory requirements and standards.
• Adds case managers and peer counselors to the list of multidisciplinary staff of clinicians that a TRC must have as a resource to crime victims.
• Specifies procedures and policies, including reporting requirements, for using funds from the SNSF, as follows:
  • Prohibits the Board from spending more than 5 percent annually of the money appropriated to it from the SNSF for administrative costs.
  • Requires the Board to annually report to the Legislature on the funding received from the SNSF with a detailed summary of the programs funded by the moneys allocated to it from the SNSF.
• Requires the Board to create an advisory committee to make recommendations on regulations governing TRC funding, the criteria for awarding grants to TRCs.
• Includes numerous uncodified and codified legislative findings and declarations.

Prior Legislation:

SB 518 (Leno) 2015 was substantially similar to this measure. SB 518 was held on the Suspense File of the Assembly Appropriations Committee.

SB 854 (Committee on Budget and Fiscal Review) Chapter 28/2014, the state and local government budget trailer bill, among its numerous provisions revised the provision conditioning TRC grants upon appropriation of the Legislature to instead state the intent of the Legislature to annually appropriate $2 million per year from the Restitution Fund for TRC grants.

SB 71 (Committee on Budget and Fiscal Review) Chapter 28/2013, the state government budget trailer bill, among its numerous provisions required that upon appropriation by the Legislature, the VCGCB award TRC grants totaling up to $2 million per year to be funded only from the Restitution Fund.

Staff Comments:

The Board has estimated the provisions of this measure would result in annual costs of $925,000. These costs include funding to facilitate the interagency agreement with UC, additional staffing to meet the operational and reporting requirements resulting from expansion of the program, data collection and software needs, and the funding to secure an evaluation contractor ($490,000). The contractor costs are estimated to constitute ten percent of the projected amount of grant funds to be distributed (currently $2 million Restitution Fund and $2.9 million estimated SNSF). Staff notes the SNSF funds available for administrative costs to the Board are limited to five percent of the total funds received by the Board from the SNSF on an annual basis ($145,000 based on the current estimate of total SNSF funds to the Board of $2.9 million in FY 2016-17). The remainder of expenditures would be supported by the Restitution Fund, which staff notes is structurally imbalanced.

The UCSF TRC currently receives approximately $1 million in local funding, $400,000 from the Federal Office on Refugee Resettlement, and about $400,000 from the Board (as a result of SB 71 noted above). SB 71 (Chapter 28/2013) established six TRC's in California based on the UCSF model and appropriated $2 million annually from the Restitution Fund to fund the TRCs (UCSF, Long Beach, Solano, Stockton, and two in Los Angeles). To the extent UC resolves to enter into the agreement, annual costs to provide the level of services required would likely be in the low millions of dollars to provide the training materials, technical assistance, and ongoing consultation to the Board and other TRCs as required under the agreement. Additionally, the agreement requires the UC to design a multisite evaluation to measure adherence to the practice and effectiveness of each TRC.

This bill would allow the Board to award multiple grants to single TRCs with overlapping terms utilizing different grant fund sources. It is unclear whether this allowance will result in unnecessary complexities in reporting and documentation requirements for both TRCs and the Board.

Recommended Amendments:

1. This bill contains numerous legislative findings and declarations. Albeit uncodified, staff recommends the following amendments to more accurately reflect the language of Proposition 47 (2014) which specifies grant funds are to be used to provide services to victims of crime:

On page 3, lines 21-23:

(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 and Government Claims Board to administer a grant program to establish make grants to trauma recovery centers to provide services to victims of crime modeled after the UCSF TRC.

1. As noted in the Background section of this analysis, SNSF funds are continuously appropriated, and are disbursed by the Controller to relevant agencies pursuant to the provisions of Proposition 47 (2014). Consequently, staff recommends an amendment on line 9 of page 8 to strike the phrase “appropriated to it” and replace with “it receives” to be consistent with the verbiage in GC § 7599.2(b) to enable the BSCC to utilize the SNSF funds disbursed by the Controller for administrative purposes.

On page 8, lines 8-10:

(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. of the total funds it receives from the Safe Neighborhoods and Schools Fund on an annual basis for administrative costs.

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SENATE COMMITTEE ON PUBLIC SAFETY

Senator Loni Hancock, Chair

2015 - 2016 Regular

Bill No: SB 1404 Hearing Date: April 19, 2016

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

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:

• 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:
  • 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.
  • 10% to the Victims of Crime Program to fund for grants to TRCs.
  • 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 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 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 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:

• 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 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.

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 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 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 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

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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1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684449/ ↑

2. http://msutoday.msu.edu/news/2012/homicide-spreads-like-infectious-disease/ ↑

3. http://www.ncbi.nlm.nih.gov/books/NBK262831/ ↑

4. http://www.cdc.gov/violenceprevention/acestudy/findings.html ↑

SENATE COMMITTEE ON HEALTH

Senator Ed Hernandez, O.D., Chair

BILL NO: SB 1404

SUBJECT: Victims of violent crimes: trauma recovery centers

SUMMARY:

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.

Existing law:

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 per year for these grants, funded from the Restitution Fund.
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 nonserious, nonviolent 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 trauma recovery centers to provide services to victims of crime; and, 65 percent to 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 all of the following:
   1. 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;
   2. 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;
   3. 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;
   4. Be comprised of a staff that includes a 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 service providers to victims of violent crime;
   5. 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;
   6. 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 community agencies, law enforcement, or other supportive service providers as needed;
   7. 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;
   8. 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;
   9. 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; and,
   10. Provide holistic and accountable services that ensure treatment will be provided for up to 16 sessions. For 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:
   1. The TR-COE to define the core elements of the evidence-based practice;
   2. The CVCGC 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 CVCGC Board and to each center to enable the grantees to replicate the evidence-based approach; and,
   4. 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% annually of the moneys appropriated to it from the SNS Fund 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 trauma recovery centers.
7. Provides the advisory committee with the authority to make recommendations to the CVCGC Board related to regulations governing funds for trauma recovery centers that are administered by the CVCGC Board, and to make recommendations related to the criteria for awarding grants to trauma recovery centers.
8. Requires the advisory committee to be composed of the following:
   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 with the state, including at least one provider who has significant experience in providing services to rural communities; and,
   3. Three people who have previously received or are current recipients of services from a trauma recovery center.
9. Provides the advisory committee with the authority 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 trauma recovery center 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 California will have increased access to needed services.

FISCAL EFFECT:

This bill has not been heard by a fiscal committee.

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.
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 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 71 (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 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. Double referral. This bill is double-referred. Should it pass out of this committee, it will be referred to the Senate Public Safety Committee.
7. Prior legislation. SB 518 (Leno, 2015), also recognized the TRC at San Francisco General Hospital as the State Pilot TRC, and was substantially similar to this bill. SB 518 was held on the Assembly Appropriations Suspense File.

SB 71 (Budget and Fiscal Review, Chapter 28, Statutes 2013) authorized the CVCGC Board to administer a program to award up to $2 million in grants annually to TRCs, funded from the Restitution Fund.

SB 733 (Leno, 2010) would have authorized the CVCGC Board to evaluation applications and award grants totaling up to $3 million, up to $1.7 million per center, to multi-disciplinary TRCs that provide specified services to and resources for crime victims. SB 733 was vetoed by the Governor.

AB 1669 (Leno, 2007) would have appropriated $1.5 million for the TRC at San Francisco General Hospital. AB 1669 was vetoed by the Governor.

AB 50 (Leno, Chapter 884, Statutes of 2006) appropriated $1.3 million for the TRC at San Francisco General Hospital.

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 the San Francisco General Hospital to demonstrate the effective ness of providing comprehensive and integrated services to victims of crime.

1. 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.
2. Suggested amendments.
   1. 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 author may wish to consider amending this provision 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.
   2. 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.

SUPPORT AND OPPOSITION:

Support: Californians for Safety and Justice (sponsor)

Crime Victims United of California

Fathers & Families of San Joaquin

Two individuals

Oppose: None received

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