SUBJECT
Title
EXPANDING CAPACITY FOR TRAUMA RECOVERY SERVICES IN SOUTH COUNTY AND DEVELOPING FUTURE SOUTH COUNTY FAMILY JUSTICE CENTER: IMPROVING SERVICES FOR CRIME PREVENTION, INTERVENTION AND VICTIM-SURVIVOR CARE THROUGH COMPREHENSIVE TRAUMA-FOCUSED SERVICES (DISTRICTS: ALL)
Body
OVERVIEW
According to a January 2020 report from the National Alliance of Trauma Recovery Centers, only about one in ten people who survive a violent crime receive direct assistance from a victim service agency. This number drops even lower when the crime is unreported-more than half of all violent crimes go unreported. Unaddressed trauma can lead to chronic emotional distress, relationship problems, and self-medicating through increased alcohol or drug use. Untreated trauma affects the survivor, their family, and the larger community and often intersects with criminal conduct and victimizations. Children who witness or experience child abuse, domestic violence, sexual exploitation, or human trafficking accumulate a challenging Adverse Childhood Experiences score (ACEs) that contributes to generational cycles of poverty and violence. Our most vulnerable and underserved survivors, especially those with culturally and ethnically diverse backgrounds, face the biggest challenges in seeking and getting support.
On September 29, 2015 (11), the Board of Supervisors (Board) approved the lease agreement for the District Attorney’s Community, Action, Resource, Engagement (CARE) Center, established with the intention of collaborating with residents, community groups and other government agencies in the development of crime prevention problem-solving initiatives. The CARE Center opened in 2016 in partnership with community stakeholders who provided insight into community needs. The CARE Center provides culturally competent services and partners with community organizations that provide services to low income and underserved populations.
This is a request to authorize the Director of the Department of Purchasing and Contracting to issue a Competitive Solicitation to expand access to culturally responsive trauma recovery services at the CARE Center in anticipation of a future South County Family Justice Center to include, but not limited to, case management, therapeutic treatments, triage and referral services, and other ancillary services for at-risk youth and adults and their families. This is also a request to authorize a single source contract with Palomar Health and Rady Children’s Hospital to provide trauma recovery services. The population focus includes crime victims, human trafficking and domestic violence survivors, reentry community members, at-risk youth, and community members who need crime prevention and intervention services. The request is for a period of one initial and four option years, with a six-month option if needed, anticipated to begin October 1, 2022.
RECOMMENDATION(S)
District attorney summer stephan AND Vice Chair NORA VARGAS
1. In accordance with Section 401, Article XXIII of the County Administrative Code, authorize the Director of the Department of Purchasing and Contracting to issue a Competitive Solicitation or Solicitations for culturally responsive and trauma focused immediate stabilization services, and subject to successful negotiations and a determination of a fair and reasonable price, award one or more contracts for up to five years anticipated to begin October 1, 2022, and an additional six months if needed, and to amend the contract(s) as needed to reflect changes to service needs or funding requirements subject to the approval of the District Attorney.
2. In accordance with Board Policy A-87, Competitive Procurement, approve and authorize the Director of the Department of Purchasing and Contracting to enter into negotiations with Palomar Health, Inc., and Rady Children’s Hospital subject to successful negotiations and a determination of a fair and reasonable price, award contracts for the delivery of trauma recovery services for crime victims and their families at the CARE Center and future South County Family Justice Center, for up to five years anticipated to begin October 1, 2022, and an additional six months if needed, and to amend the contract as needed to reflect changes to service needs or funding requirements subject to the approval of the District Attorney.
EQUITY IMPACT STATEMENT
The CARE Center provides culturally competent services and partners with community organizations that provide services to low income and underserved populations.
Since its opening in 2016, the center has welcomed nearly 20,500 members of underserved surrounding communities. Just in the last year alone, the CARE Center has distributed food to over 5,000 families. The top needs of the adults assessed at the CARE Center include basic needs such as housing, food/nutrition, and clothing/toiletries in addition to employment services, and mental health, the top needs of youth participants are family mediation/functioning and pro-social activities.
Of the 1,000 adults assessed between October 2017 to September 2020, 77% were of diverse ethnic background, 69% of the participants reported having at least some experience with traumatic events, 48% of those reported still being affected by the traumatic events. Providing access to immediate, trauma-focused comprehensive services will provide the most vulnerable communities in South County with an equal opportunity to avoid the negative consequences of untreated trauma.
FISCAL IMPACT
Trauma Recovery Services
If approved, funds for today’s request will be included in the Fiscal Years 2022-24 CAO Recommended Operational Plan for the District Attorney’s Office. This request will result in estimated annual costs and revenue of $1,000,000 in Fiscal Year 2022-23. The funding source is Proposition 172 Special Revenue Fund fund balance. Subsequent years costs and revenue will be included in future operational plans. There will be no change in net General Fund cost and no additional staff years.
BUSINESS IMPACT STATEMENT
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Details
ADVISORY BOARD STATEMENT
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BACKGROUND
The County of San Diego District Attorney’s Office (SDCDA) is the largest provider of local victim services assisting approximately 15,000 crime victims annually. However, community members especially victims of violent crime often experience acute crisis and continue to face challenges accessing supportive mental health and trauma services, safety plans to exit violent relationships and necessary employment and housing to live free of violence and in dignity. Some primary hurdles preventing access to critical resources and services they need are (1) proximity or access to those services, (2) timeliness of engagement and (3) complexity of navigating the resources available.
On September 29, 2015 (11), the Board of Supervisors (Board) approved the lease agreement for the District Attorney’s CARE Center, established with the intention of collaborating with residents, community groups and other government agencies in the development of crime prevention problem-solving initiatives. Located within the South County in National City, the CARE Center is a resource hub where at-risk youth and adults, victims and their families can engage in the re-establishment of safety, address treatment and support needs, and enhance skills. The CARE Center establishes multi-disciplinary partnerships with culturally responsive community providers and delivers coordinated and effective services to at-risk youth and adults, victims, and families, including but not limited to victims of child abuse, sexual assault, human trafficking, and elder abuse.
The CARE Center applies evidence-based practices by conducting individualized assessments for at risk youth and adults to accurately connect them with government and community-based services. The CARE Center currently connects participants to services including mental health counseling, family mediation, employment training and connections, housing, transportation, and more. It also provides individuals and community-based organizations with a computer lab and meeting space that supports their personal and professional goals while strengthening community ties and partnerships.
Assessments conducted at the CARE Center indicate an increasing need for immediate and comprehensive services to address trauma and avoid the negative consequences of untreated trauma, which is the most effective, humane, and cost-efficient manner to interrupt lifetime consequences of crime, mental health and substance abuse struggles and homelessness.
This Board action has an immediate goal based on a pressing need to expand the capacity and services at the existing CARE center to serve vulnerable victims of domestic violence, sexual assault, child abuse and human trafficking along with individuals and families suffering from trauma related to crime such as the loss of a parent, school shooting or other related violence. This Center would also continue to serve individuals wanting to reenter the community and live a healthy and crime free life and provide for their families.
The longer-term goal is to site and build a South County Family Justice Center as part of the best practices vision for crime prevention and dignity for victims and survivors. The expansion of trauma recovery services at the CARE center will allow for services to immediately begin and address the existing gap and needs of the South County communities.
The South region is home to more than 600,000 residents, not counting the over 265,000 residents living in the Baja California region. Being one of the busiest land ports of entry in the Western Hemisphere, the San Ysidro Port of Entry uniquely interconnects South San Diego County with our partners in the South. Sixty percent (60%) of the residents in this region speak a non-English language at home, nearly double that of the amount of the entire San Diego region (36%). Fifteen percent (15%) of the individuals in this region are in poverty and 25% have less than a high school education. Currently, individuals access services through a complicated network that intertwines between income-based service providers and health insurance (state funded and/or private.) For at-risk youth and adults, this quickly becomes very daunting because of agency time, strict qualification guidelines, and extensive waitlists.
Addressing the needs of victims early can interrupt cycles of violence and poverty. There are even more obstacles to access services for someone who is a victim, and who then becomes a defendant, or vice versa, because of eligibility and funding requirements related to serving victims. Today’s action aims to enhance and expand trauma recovery and resiliency services at the CARE Center to help provide accessible, immediate, and effective services that are indispensable to break this cycle. Unaddressed trauma can lead to heightened risk for emotional instability, mental health issues, future victimization, or crime and further intersections with law enforcement; therefore, serving community members experiencing trauma aligns with the District Attorney Office’s focus on prevention and protection.
The CARE Center model also aligns with the County’s approach to address crime prevention through services and invest in the root causes that lead to certain behaviors. It supports recently established County initiatives that seek to enhance care and create accessible trauma-focused support services for at-risk individuals and their families.
As mentioned in the Board Letter, from March 2, 2020, board letter that created the Initiative to Uplift Boys and Men of Color led by Vice Chair Nora Vargas and Chair Nathan Fletcher, “an individual’s zip code can determine access to services” and the County must “continue removing unnecessary barriers and strengthen our implementation of a holistic approach to those in need.”
Most recently on January 25, 2022, Vice Chair Nora Vargas introduced and received unanimous support for a board letter that seeks to continue and expand the County’s commitment to provide critical services and support to survivors of human trafficking. We believe that enhancing and expanding the CARE Center’s trauma services will create a space for survivors of human trafficking and other trauma to start their journey to heal and recover.
The main purpose of these additional and enhanced services is to continue to support victims of trauma by connecting them to immediate holistic services for the prevention of future crime or victimization. While victims receive immediate services, CARE staff will connect them to longer term care with the Health and Human Services Agency (HHSA). As the County develops a model of community health workers and peer support specialists, through the HHSA Department of Homeless Solutions and Equitable Communities and the HHSA Department of Behavioral Health Services, respectively, we should explore how to promote programs and services offered to victims and survivors of crimes through these models while simultaneously addressing cultural competence. Given the nature of our multi-cultural binational region, it is essential that resources offered in the South location are inclusive, culturally competent, in-language and demonstrate an understanding of who we are as a region including those with families living on both sides of the border and the additional challenges that we may face due to this binational reality.
This Board action is consistent with the District Attorney’s goal outlined in previous board letters focused on regionalizing the Family Justice Center Model which is considered a national best practices model for harm reduction from violent crime. With the Board’s support, the North County Family Justice Center will open this year, and a South County Family Justice Center is the next step in the provision of the access to all communities plan. The enhancement and expansion of services at the CARE Center is the first step in addressing the gap in the South County trauma recovery services, and meets the immediate goal based on a pressing need to serve vulnerable victims of domestic violence, sexual assault, child abuse and human trafficking along with individuals and families suffering from trauma related to crime such as the loss of a parent, school shooting or other related violence. This Center will continue to serve individuals wanting to reenter the community and live a healthy and crime free life and provide for their families. The longer-term goal is to site and build a South County Family Justice Center as part of the best practices vision for crime prevention and dignity for victims and survivors.
This expansion will leverage existing resources and add community based needed resources in order to address the needs of the South County community. The District Attorney’s Office would return to the board to seek approval as needed and work with the Department of General Services to determine an equitable location, size, and design. Potential options include expansion by incorporating suites adjacent to the CARE Center, or by acquiring a new dedicated facility for a South County Family Justice Center (One Safe Place South).
Furthermore, the CARE Center continues to maintain relationships with community stakeholders to work together to build community resiliency. Their voices and ideas are heard through monthly stakeholder’s meetings, which aligns with the County’s priority of increasing access and transparency. Through this process, the CARE Center enhances partnerships with culturally relevant community-based organizations, providing trauma informed care to ensure participants receive care that is sensitive to their specific needs, culture, and background.
This is a request to authorize the Director of the Department of Purchasing and Contracting to issue a Competitive Solicitation to provide trauma-focused services to include but not limited to: case management, therapeutic treatments, triage and referral services, and other ancillary services for at-risk youth and adults and their families. This is also a request to authorize a single source contract with Palomar Health and Rady Children’s Hospital to provide trauma recovery services. The target population includes crime victims, human trafficking and domestic violence survivors, reentry community members, at-risk youth, and community members who need crime prevention and intervention services. The request is for a period of one initial and four option years, with a six-month option if needed, anticipated to begin October 1, 2022.
This proposal is an opportunity to invest in the well-being of our South County communities by providing an accessible space to seek the services needed to prevent crime and victimization.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the Justice Initiative in the County’s 2022-2027 Strategic Plan by ensuring a fair and equitable justice system for support and services for victims, enhancing access to essential resources and programs that assist at-risk youth, adults, and victims of crime throughout their recovery.
Respectfully submitted,
Summer S. Stephan Nora Vargas
District Attorney Supervisor, 1 District
ATTACHMENT(S)
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