0809041.17 COMMISSIONERS' COURT AGENDA REQUEST PLEASE FURNISH ONE ORIGINAL AND NINE COPIES OF THIS REQUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT. MADE BY: H.A. "Buster" Baldwin OFFICE: Commissioner, Pct. 1 MEETING DATE: August 9, 2004 TIME PREFERRED: SUBJECT: (PLEASE BE SPECIFIC) Discuss Kerr County Crime Victim Assistance Coordinator. (DISCUSSION ONLY) EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON) NAME OF PERSON ADDRESSING THE COURT: Comm., Pct. 1/David Motley ESTIMATED LENGTH OF PRESENTATION: IF PERSONNEL MATTER -NAME OF EMPLOYEE: Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter 551 and 552, Government Code, is as follows: Meeting scheduled for Mondays: 5:00 P.M. previous Tuesday. THIS REQUEST RECEIVED BY: THIS REQUEST RECEIVED ON: All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will be appreciated and contribute towards you request being addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners' Court. Kerr County Crime Victim Assistance Coordinator For almost a decade a part of the court costs assessed to those persons convicted of crimes in the Texas judicial system has gone into a state crime victims' compensation fund. In order for victims or their family to benefit from the funds a victim impact statement must be filed within three years. Texas Code of Criminal Procedure Chapter 56. Rights of Crime Victims Article 56.02 Crime victims' rights (attached copy) Article 56.03 Victim impact statement Article 56.04 Victim assistance coordinator; crime victim liason a) The district attorney, criminal district attorney, or county attorney who prosecutes criminal cases shall designate a person to serve as victim assistance coordinator in that jurisdiction. b} The duty of the victim assistance coordinator is to ensure that a victim, guardian of a victim, or close relative of a deceased victim is afforded the rights granted victims, guardians, and relatives by Article 56.02 of this code. The victim assistance coordinator shall work closely with appropriate law enforcement agencies, prosecuting attorneys, the Board of Pardons and Paroles, and the judiciary in carrying out that duty. Kerr County, with a population of almost 45,000 residents, has no single person designated to work with crime victims or families on a consistent basis. Each district attorney has staffwithin their office, as does the county attorney, who have been designated to see that families are made aware of the option. Often, because of their other responsibilities, they do not have time to do the follow-up needed with the victims or families. The Governor's Criminal Justice Division provides grant money and the Alamo Area Council of Governments manages grants for Crime Victims Services. Many counties in Texas, including nearby Kendall County, have full time crime victim assistance coordinators. District Attorney Bruce Curry has offered to apply for a grant to fund the position in Kerr County. County Attorney David Motley and County Attorney-Elect Rex Emerson also have indicated support of the creation of the position within the nett year. AACOG grant applications are done in the fall of the year and the funding goes from July 1 to June 30. The grant is an 80 percent grant with the county providing the other 20 percent. Proposal: To create a position to be titled: Kerr County Crime Victim Assistance Coordinator during the 2004-2005 budget year. The first 9 months of the year the position would be half- time but beginning July 1, 2005 would go to full-time if grant money is secured to fund the program. Possible funding for the position until June 30, 2005, could come from the county attorney's budget and funds from both the 198th and 216th district attorneys. County Attorney David Motley has indicated be may have some funds available for the last part of the 2003-2004 budget year also which could make possible the start- up of the program as early as August. Duties of the Kerr County Crime Victim Assistance Coordinator 1. Contact victims and families of victims who live in Kerr County who currently have specified cases pending in the courts. Specifically victims of family violence, sexual assault, aggravated assault, or other violent crimes against persons and families of murder victims. 2. Be available during limited office hours to work with crime victims who contact the CVAC for assistance in filing paperwork to seek state funds. Law enforcement officers will forward information to the CVAC on persons that need to be contacted. 3. Be available for call-out to crime scenes to work with victims (both adult and juvenile) if the need for immediate intervention is determined by law enforcement officers at the time. 4. Refer crime victims to other social service agencies in the community as appropriate and work with those social service agencies to help victims if needed. 5. Work with the district attorneys and judges to be sure victims' rights are protected throughout the period that the case is pending in court and once the case is adjudicated. Keep the victim or family of victim informed of what is going on in the court process. Crime Victim Assistance Coordinator Additional Back-up Information: 1. Kendall County 2003-2004 Budget 2. Copy of Chapter 56-Code of Criminal Procedure related to Crime Victim Rights and Role of Crime Victim Assistance Coordinator 3. Copy of Application for Crime Victims' Compensation Application to Attorney General Greg Abbott Grant Budget Legal Name of Organization: Kendall County, Texas Title of Project: Crime Victim Services Grant Period: From: 07/01/2003 To: 06/30!2004 Grant Number: VA-02-V30-14946-04 BUDGET D ETAIL Minimum Cash Match Percentage: 20% ENTER CJD Requested Amount: $45,485 ENTER Program Income (If Applicable): $0 ~ Minimum Cash Match: $11,875 Tota l Project Costs: $59;373 PERSONNEL o o ase Salary CJD Funds Match In-kind Total Crime Victim Coordinator 100% $32,000 $0 $0 $32,000 FICA 100% $3,183 $0 $0 $3,183 Retirement 100% $2,300 $0 $0 $2,300 Insurance and Workers Comp, S5 100% $3,754 $0 $0 $3,754 Volunteers (360 hrs. @ $6.00 = $2,160) 100% $0 $0 $2,160 $2,160 County Attorney will provide legal advocacy for victims of violent crime, including protective orders and assault cases. 13% $0 $5,175 $0 $5,175 ., ~ ._.. .. __. ,. an v., .. _.~. ,. ... CONTRACTUAL AND PROFESSIONAL SERVICES ... _„ _ _ CJD Funds _. Match In-kind Total Counseling: (22 hrs. @ $40. _ $880)Individual and group counseling for victims of domestic violence, and all assault. $0 $0 $880 $880 TRAVEL AND TRAINING CJD.Funds Match In-kind Total Local Travel !5,469 miles @ $.32/mile = $1,750)respond to needs of victim of violent crime in a rural area; transport victim & family to shelter in neighboring county, provide transportation to food bank, physician, interview victim and court dates. (7,040 miles @ .32 cents/mile). 1,128 1,125 0 2,253 In State Travel:Training Conferences for CVS Coordinator and 2 volunteeers to attend training conferences to provide essential services to victims and their families. Registration, hotel and $25 per diem per person per day, 1,094 miles @ /32 cents/mile = 350 miles). 500 v.~5i; i WJ 850 ..~.. EQUIPMENT CJD funds Match In-kind Total None $0 $0 $0 $0 SUPPLIES AND DIRECT OPERATING EXPENSES CJD Funds Match In-kind Total Office Supplies: $1,730(stationary, postage, pens, toner, copy paper, file folders. $500 $1,730 $0 $2,230 Communication Costs: $2,120 Cell phone for responding to victims in rural area 24 hours, long distance within the county. $2,120 $0 $0 $2,120 Printing of new Protective Order Protocol Manual by local business- English and Spanish. $0 $0 $600 $600 ... ,,... a.~,........_ .. .. _:...._ INDIRECT COSTS (the Direct Costs Against Which the Indirect Rate is Char ed . ,n ... CJD Direct Costs Match Direct Costs Indirect Rate Total None $0 $0 0.00% $0 BUDGET SUMMARY BUDGET CATEGORIES CJD MATCH IN-KIND TOTAL PERSONNEL $41,237 $5,175 $2,160 $48,572 Page 1 of 2 Budget CONTRACTUAL AND PROFESSIONAL SERVICES $0 $0 $880 $880 TRAVEL AND TRAINING $2,128 $1,475 $0 $3,603 EQUIPMENT $0 $0 $0 $0 SUPPLIES AND DIRECT OPERATING EXPENSES $2,120 $1,730 $600 $4,450 TOTAL. DIRECT COSTS: $45,485 $8 380 $3,640 $57,505 INDIRECT COSTS $0 $0 $0 $0 TOTAL: $45 485 $8,380 $3,640 $57,505 Total Match: $12,020 ~ Actual Cash Match Percentage: 20.9% Page 2 of 2 Budget _ oc e o _. r~ nr na = rocec ure - _ -_~ . - . _- .. CHAPTER 5~~ . RIGHTS OF CFcIi~ VICTiM~~ SUBCHA]~TEFc A. CRIME VICTIMS' RIGHTS Art. 56.01. Definitions In this chapter: (1) "Close relative of a deceased victim" means a person who vaas tre spouse of a deceased tri~_ai;al at the time of the victim's death or who is a parent or adult brother, sister, or child of the deceased victim. (2) "Guardian of a victim" means a person who is the legal guardian of the victim, whether or not the legal relationship between the guardian and victim exists because of the age of the victim or the physical or mental incompetency of the victim. (3) "Victim" means a person who is the victim of sexual assault, kidnapping, or aggravated robbery or who has suffered bodily injury or death as a result of the criminal conduct of another. Added by Acts 1985, 69th Leg., ch. 588, § 1, eff. Sept. 1, 1985. Art. 56.02. Crime victirrls' rights (a) A victim, guardian of a victim, or close relative of a deceased victim is entitled to the following rights within the criminal justice system: (1) the right to receive from law enforcement agencies adequate protection from harm and threats of harm arising from cooperation with prosecution efforts; (2) the right to have the magistrate take the safety of the victim or his family into consideration as an element in fixing the amount of bail for the accused; (3) the right, if requested, to be informed: (A) by the attorney representing the state of relevant court proceedings, including appellate proceedings, and to be informed if those proceedings have been canceled or rescheduled prior to the event; and (B) by an appellate court of decisions of the court, after the decisions are entered but before the decisions are made public; http_//www. capitol .state. tx.us/cgi-bin/cgcgi?CQ_SESSION_KEY=XNHJAENHVJGP&C... 4/28/2003 _oceo _rrn~na -rc>eecure-..-~.- --,-~, -",.rt~-,„ -., (4 ) i.he r__g~.t t~ _~ b ~ __:- :_ ~> rn.ed, when requested, by a peace o ~ fi-,.er ~oncern__ng '.he defE~r.da~. _' ~. right to bail and the procec._~__ a:. ir. ~r__mina-'_ ins~estigation., ~~n,i by the district attorney`s cfif:_cF concerning t._-~e ;general _orocedures in the criminal justice s_,~st.:~r~., including general procedures in guilty plea negotiaticnti. ~~nd 3rrangeMents, restitut=ion, and the appeals and parole process; (5) the right to provide pertinent information to a probat_on det>artmen'~ conducting a presentencing investigation concerning the impact of the c.ffersE~ on the victim and his family by testimony, written statement, or any other manner prior to any sentencing of the offender; (6) the right to receive information regarding --.. , ..- .-.. to -;-,_ of .-:_.,~.~_. as provided by Subchapter B, including information related to the costs that may be compensated under that subchapter and the amount of compensation, eligibility for compensation, and procedures for application for compensation under that subchapter, the payment for a medical examination under Article 56.06 for a victim of a sexual assault, and when requested, to referral to available social service agencies that may offer additional assistance; (7) the right to be informed, upon request, of parole procedures, to participate in the parole process, to be notified, if requested, of parole proceedings concerning a defendant in the victim's case, to provide to the Board of Pardons and Paroles for inclusion in the defendant's file information to be considered by the board prior to the parole of any defendant convicted of any crime subject to this subchapter, and to be notified, if requested, of the defendant's release; (8) the right to be provided with a waiting area, separate or secure from other witnesses, including the offender and relatives of the offender, before testifying in any proceeding concerning the offender; if a separate waiting area is not available, other safeguards should be taken to minimize the victim's contact with the offender and the offender's relatives and witnesses, before and during court proceedings; (9) the right to prompt return of any property of the victim that is held by a law enforcement agency or the attorney for the state as evidence when the property is no longer required for that purpose; (10) the right to have the attorney for the state notify the employer of the victim, if requested, of the necessity of the victim's cooperation and testimony in a proceeding that may necessitate the absence of the victim from work for good cause; http:Uwww. capitol. state-tx.us/cgi -bin/cgcgi?CQ_SESSION_KEY=XNHJAENHVJGP&C... 4/28/2003 Cocle of Crimina~ ~~rocecure - a_ ~-"f~ , ~ _. _'. ~6 -a{~e _~ v -- (1"'.~) the ricrht i,o c~:~ar_s~=___ng, on request, regarding acquire_t inmunF deficiency ~>yndrome (~.-.~~;>. and human immunodeficiency virus ;H=.v infection a_~d testing for acquired immune deficiency syndrome (AIDS), human immuncdeficienc~ tir~is (HIV) infection, antibodies to HIV, or infection ~,~ith any ot=hE.r probable causative agent of AIDS, if the ofi_en:~e is an o::fen;.5E_ under Section 21.11 (a) (1} , 22.011, or 22.021, Penal Code; (12) the right to request victim-offender mediation coordinated by the victim services division of the Texas Department of Criminal Justice; and (13) the right to be informed of the uses of a victim impact statement and the statement's purpose in the criminal justice system, to complete the victim impact statement, and to have the victim impact statement considered: (A) by the attorney representing the state and the judge before sentencing or before a plea bargain agreement is accepted; and {B} by the Board of Pardons and Paroles before an inmate is released on parole. (b) A victim, guardian of a victim, or close relative of a deceased victim is entitled to the right to be present at all public court proceedings related to the offense, subject to the approval of the judge in the case. {c} The office of the attorney representing the state, and the sheriff, police, and other law enforcement agencies shall ensure to the extent practicable that a victim, guardian of a victim, or close relative of a deceased victim is afforded the rights granted by Subsection (a) of this article and, on request, an explanation of those rights. (d) A judge, attorney for the state, peace officer, or law enforcement agency is not liable for a failure or inability to provide a right enumerated in this article. The failure or inability of any person to provide a right or service enumerated in this article may not be used by a defendant in a criminal case as a ground for appeal, a ground to set aside the conviction or sentence, or a ground in a habeas corpus petition. A victim, guardian of a victim, or close relative of a deceased victim does not have standing to participate as a party in a criminal proceeding or to contest the disposition of any charge. Added by Acts 1985, 69th Leg., ch. 585, § 1, eff. Sept. 1, 1985. Subsec. (a) amended by Acts 1987, 70th Leg., ch. 433, § 1, eff. Aug. 31, 1987; Subsecs. (a), (c) amended by Acts 1987, 70th Leg., ch. 929, http://www_ capitol .state.tx.us/cgi -bin/cgcgi?CQ_SESSION_KEY=XNHJAENHVJGP&C ... 4/28/2003 '_ oc e o .. r m rra roeee.u.r-i~ - ~ -.~ ~ - _.. ~ , ~ - - --- ~~ - , ~ _, Ef:=. :-;e~>t. 1, 19~~-; Slb_ac. (c) amended by Acts 1989, 71:;t: I_E-;~., ~h.. c~c;t=., F> _., e~=f . 3~~F~t . __, 1989; Subsecs. (a) , (d) amended ; _ ~.;,t~ 1991, 7~nd =peg., c'z. -~)-', °~ 3, eff. Sept. 1, 19 91; Subsf_~:: . ;a' amended by ~~~ts 199:3, i3r~~l Leg., ch. 811, § 3, eff. Sept. 1, 19~~3; 3ubsec. (a) (F~} amender h~~ -?acts 1995, 74th Leg., ch. 76, § 5. ~~'; 1108} , ~f~-. Sept. 1, 1995; S~~N~,ecs. (a} , (b) amended by Acts 2001, 7"nth Leg., ch. 1 ~~..4, § 3, eff. Sept. 1, 2001. Art. 56 _ 03. '.'i.;~r__.rs impact statement (a) The Texas C:~~me v"~ c, t:_-r~ Clearinghouse, with the participation cf the Texas Adult Probation Commission and the Board of Pardons and Paroles, shall develop a form to be used by law enforcement agencies, prosecutors, and other participants in the criminal justice system to record the impact of an ~f?e-~se on a victim of the offense, guardian of a j.riutim, or a close relative of a deceased victim and to provide the agencies, prosecutors, and participants with information needed to contact the victim, guardian, or relative if needed at any stage of a prosecution of a person charged with the offe:Ase. The Texas Crime ''~iCtiIt1 Clearinghouse, with the participation of the Texas Adult Probation Commission and the Board of Pardons and Paroles, shall also develop a victims` information booklet that provides a general explanation of the criminal justice system to victims of an offe.,s~, guardians of i,"it.t`_s;` ~, and relatives of deceased victims. (b) The victim impact statement must be in a form designed to inform a victim, guardian of a victim, or a close relative of a deceased victim with a clear statement of rights provided by Article 56.02 of this code and to collect the following information: (1) the name of the _ctir.; of the c:ffQ:;se or, if the z.-icti:~: has a legal guardian or is deceased, the name of a guardian or close relative of the victim; (2) the address and telephone number of the victim, guardian, or relative through which the victim, guardian of a victim, or a close relative of a deceased victim, may be contacted; (3) a statement of economic loss suffered by the victim, guardian, or relative as a result of the offense; (4) a statement of any physical or psychological injury suffered by the victim, guardian, or relative as a result of the of~e_.se, as described by the victim, guardian, relative, or by a physician or counselor; (5) a statement of any psychological services requested as a result of the offense; http://www.capitol.state.tx.us/cgi-bin/cdc~i?CQ_SESSION_KEY=XNHJAENHVJGP&C... 4/28/200 OCC O : ., I` ITT" "? Cl - '~C~LCC.'_'."E' - ~. -.t ~- ~ _. .. - - - , (r•; a ~tat.ernent: oi~ ar.z~ c~~ange in the victim's, guardi~_.`s, c.=~ relative' .~ pE,rson<~l ~,E,=_ f ac ,: .,r familial relationship as a r _~._ _il t c f the :: f f G~r!,_ ;; . (7; a statement as to w:-Tether or not the victim, guardi,_~n, c.r re= ative ~.~ishes t:o be nog, i fled in the future of any parole h>>ar~nc~ foT- t:he defendant and an explanat ion as to the procedures ~y wh_ch the zr_cti_m, guardian, cr relative may obtain information concerning the release of the defendant from the Texas Departme-~t cf cor rections; and (8! any other information, other than facts related to the commissicn of the of{c~nse, related to the impact of the of fer:se on the •..c:#-.:_::~, guardian, or relative. (c? The victim assistance coordinator, designated in Article 56.04(a) of this code, shall send to a victim, guardian of a vir_tim, or close relative of a deceased victim a victim impact statement, a -.?i .:%' :.rn:= ' information booklet, and an application for cornpensaticr: under Subchapter B, Chapter 56, along with an offer to assist in completing those forms on request. The victirr~ assistance coordinator, on request, shall explain the possible use and consideration of the victim impact statement at sentencing and future parole hearing of the offender. (d} If a victim, guardian of a victim, or close relative of a deceased victim states on the victim impact statement that he wishes to be notified of parole proceedings, the victim, guardian, or relative is responsible for notifying the Board of Pardons and Paroles of any change of address. (e) Prior to the imposition of a sentence by the court in a criminal case, the court, if it has received a victim impact statement, shall consider the information provided in the statement. Before sentencing the defendant, the court shall permit the defendant or his counsel a reasonable time to read the statement, excluding the victim's name, address, and telephone number, comment on the statement, and, with the approval of the court, introduce testimony or other information alleging a factual inaccuracy in the statement. If the court sentences the defendant to a term of community supervision, the court shall forward any victim's impact statement received in the case to the community supervision and corrections department supervising the defendant, along with the papers in the case. (f} The court may not inspect a victim impact statement until after a finding of guilt or until deferred adjudication is ordered and the contents of the statement may not be disclosed to any person unless: (1) the defendant pleads guilty or nolo contendere or is convicted of http://www.capitol.state.tx.us/cgi-bin/cgcgi?CQ_SESSION KEY=XNHJAENHVJGP&C... 4/28/2003 Code of Criminal Procedure -CHAPTER 56 Page 6 of 47 the offense; or (2) the defendant in writing authorizes the court to inspect the statement. (g) A victim impact statement is subject to discovery under Article 39.14 of this code before the testimony of the vi~,tim is taken only if the court determines that the statement contains exculpatory material. (h) Not later than December 1 of each odd-numbered year, the Texas Crime "~~[~tirit Clearinghouse, with the participation of the Texas Adult Probation Commission and the Board of Pardons and Paroles, shall update the victim impact statement form and any other information provided by the commission to victims, guardians of victims, and relatives of deceased ~~ictims, if necessary, to reflect changes in law relating to criminal justice and the rights of victims and guardians and relatives of victims. (i) In addition to the information described by Subsections (b)(1)- (8), the victim impact statement must be in a form designed to collect information on whether, if the victim is a child, there is an existing court order granting to the defendant possession of or access to the victim. If information collected under this subsection indicates the defendant is granted access or possession under court order and the defendant is subsequently confined by the Texas Department of Criminal Justice as a result of the commission of the offense, the Zvi^_t.i.m services office of the department shall contact the court issuing the order before the defendant is released from the department on parole or mandatory supervision. Added by Acts 1985, 69th Leg., ch. 588, § 1, eff. Sept. 1, 1985. Subsecs. (a), (c) amended by Acts 1987, 70th Leg., ch. 929, § 2, eff. Sept. 1, 1987; Subsec. (e) amended by Acts 1987, 70th Leg_, ch. 433, § 2, eff. Aug. 31, 1987; Subsec. (h) added by Acts 1987, 70th Leg., ch. 929, § 3, eff. Sept. 1, 1987; Subsec. (c) amended by Acts 1989, 71st Leg., ch. 996, § 2, eff. Sept. 1, 1989; amended by Acts 1995, 74th Leg., ch. 76, § 5.95 (108} , eff. Sept. 1, 1995; Subsec. (i} added by Acts 1997, 75th Leg., ch. 670, § 5, eff. Sept. 1, 1997; Subsec. (e) amended by Acts 2001, 77th Leg., ch. 1034, § 4, eff. Sept. 1, 2001. Art. 56.04. t'ictim assistance coordinator; cry_mE ~.r~_ct~rr-~ liaison (a) The district attorney, criminal district attorney, or county attorney who prosecutes criminal cases shall designate a person to serve as victim assistance coordinator in that jurisdiction. (b) The duty of the victim assistance coordinator is to ensure that a http: Uwww. capitol . state. tx.us/cgi -bin/cgcgi?CQ_SESS I ON_KEY=XNHJ AENHVJGP& C ... 4/28/2003 Coc e o' C riming 'rocecure - ~ - f~ = ~ ~ Y..~~~ ~a<~e ~ o: ~- i.ct_1;r , guardian of a r ~_: -.: n , or close relative of is afforded the rights =r:cn'_ed victims, guardians, ~rt=ic.le 56.OZ of th._s cede. The victim assistance wor}; closely with ap_~rocr__ate law enforcement age attorneys, t:~e Board o== Far~~ons and Paroles, and carrying ou ~ that du ~~~. a deceasedr - -: c ~-_ and rela t .1 ~-es l coordinat:~r ~hal~ «cies, prc,~ecL:t=_ncr the judir_iar~~ ir_ (c; Each local -_aw enforcement agency shall designate one person to serve as the agency's ... _, .. -.-:.~~:ti;:. liaison. Each agency shall consult with the -V~i ~ '_. r:, assistance coordinator in the office of the attorney representing the state to determine the most effective manner in which the _.. a_: ~~.~ ~. r ~. _._,. liaison can perform the duties imposed on the ~;;r.:..-~:=; ~. .~..._..:: liaison under this article. (d) The duty of the -~ ~ - =- .--°: _ -?'^ liaison is to ensure that a ~.- ~~t.:.--;, guardian of a -...:. : ., ., or close relative of a deceased ~; ~.cti:-~. is afforded the rights granted ?r-ir_tims, guardians, or close relatives of deceased wTict~ms by Subdivisions (4), (6), and (9) of Article 56.02 (a) o f t his code . (e) The z_~ictiirt assistance coordinator shall send a copy of a ~Ti.--i-~ impact statement to the court sentencing the defendant. If the court sentences the defendant to imprisonment in the Texas Department of Corrections, it shall attach the copy of the Y.r;.ctirr; impact statement to the commitment papers. Added by Acts 1985, 69th Leg., ch. 588, § 1, eff. Sept. 1, 1985. Amended by Acts 1989, 71st Leg., ch. 996, § 3, eff. Sept. 1, 1989; Subsec. (a) amended by Acts 1991, 72nd Leg., ch. 202, § 4, eff. Sept. 1, 1991 . Art. 56.045. Presence of Advocate or Representative During Forensic Medical Examination (a) Before conducting a forensic medical examination of a person who consents to such an examination for the collection of evidence for an alleged sexual assault, the physician or other medical services personnel conducting the examination shall offer the person the opportunity to have an advocate from a sexual assault program as defined by Section 420.003, Government Code, who has completed a sexual assault training program described by Section 420.O11(b), Government Code, present with the person during the examination, if the advocate is available at the time of the examination. (b) The advocate may only provide the injured person with: (1) counseling and other support services; and (2) information regarding the rights of „:~~m ~ -.:~ ;::`~_; .~~ under Article httpa/www. capitol .state.tx.us/cgi-bin/cgcgi?CQ_SESSION_KEY=XNHJAENHVJGP&C... 4/28/2003 ATTORNEY GENERAL OF TEXAS GREG ABBOTT P For Texas Crime Victims' Compensation Benefits Please read the directions ~n this page before completing the application. • Reading thase instructions will help you complete each section correctly. - Include all the documentation you can - if you have a copy of the police report, protective order with affidavit, hospital or doctor bills, be sure to send them with the application. • If you do not have this documentation do not wait to mail the apr~lication. Send the applica- tion as soon as you have completed it. Collect all other additional information so that you will have it when we contact you. • Keep this front page so that you will have our ::address and phone number. Mail your completed application to: Office of the Attorney General Crime Victims' Compensation (011) P.O. Boy: 12198 Austin, Texas 78711-2198 • If your address or phone number changes it is important that you call acid let us know. - The toll free number for victims, family members, and service providers is 1-800-983-9933. - Austin callers should use 936-1200. • If you need help completing this application, contact your local law enforcement agency's Crime Victim Liaison or your local District Attorney's Victim Assistance Coordinator. The Crime Victims' Compensation staff is also available to help. NOTA: Si tiene alguna pregunta sobre esta solicitud o si la desea en espanol, favor de Ilamar a to Division de Compensacibn para las Victimas de Crimen al 1-512-936-1200 0 1-800-983-9933. GENERAL INFORMATION What is the Crime Victims' Compensation Program? • May provide financial assistance to victims of violent crime for related expenses that cannot be reimbursed by insurance or other sources. • Is administered by the Office of the Attomey General, which is committed to assisting victims who qualify under the statu- tory guidelines of the Texas Crime Vctims' Compensation Act (Texas Code of Criminal Procedure, Chapter 56) and the pro- cedures under 1 Texas Administrative Code, Part III, chapter 61. • Money in the Compensation Fund comes from fees paid by those convicted of a crime. What are the basic conditions to be eligible for Crime Victims' Compensation benefits? • The victim must be a resident of Texas, a United States res- ident who is victimized while in Texas, or a Texas resident vic- timized in another state or country that does not have a com- pensation fund. • The victim must report the crime to law enforcement within a reasonable amount of time so as not to hinder the investiga- tion or prosecution of the offense, unless there is a valid exception. • The victim must cooperate with law enforcement officials in the investigation and prosecution of the case. • Benefits may be denied or reduced if the victim's own behav- ior contributed to the crime. • All other available sources or reimbursements, inch ~~iing Medicare and Medicaid, personal nealtn insurance, civil suit recovery or settlement, or court ordered restitution to the com- pensation program, must be used. • The Compensation Program must be notified when a civil lawsuit is filed related to the crime or if restitution is ordered. • Anyone injured in a motor vehicle accident, unless the driver intentionally caused the injury, was driving while intoxicated, failed to stop and render aid, or caused the injury or death of the victim due to criminal negligence or manslaughter. • Anyone incarcerated in a penal institution when the crime occurred. • Any victim or claimant who provides false or forged informa- tion to the Crime Victims' Compensation Program. What expenses may be covered with Crime Victims' Compensation benefits? • Reasonable medical, hospital, counseling, and funeral expenses. • Loss of earnings or support. • Counseling for immediate family members of the victim. • Reasonable attorney fees for assistance in filing the applica- tion and obtaining benefits. • Eyeglasses, hearing aids, dentures, or prosthetic devices if damaged or needed as a result of the crime. • Certain related travel expenses. • Crime scene clean-up. • Property seized as evidence. • Necessary expenses related to new child or adult dependent care needs. • One-time relocation expenses for victims of family violence or sexual assault in victim's residence. • Emergency awards in cases of extreme need. What expenses are not covered by Crime Victims' Compensation benefits? • Property damage or loss. • Pain and suffering. • Expenses not directly resulting from the crime. • Travel expenses to and from a funeral. Who may be eligible for Crime Victims' Compensation benefits? • Victims of violent crime who sustain emotional or physical injury as a direct result of the crime. • Dependents of a victim and immediate family members. • Persons who have a legal responsibility or who assume financial responsibility for covered bills or expenses. Who is not eligible for Crime Victims' Compensation benefits? Tex. Gov't Code Ann. §559.003(a) (Vernon Supp. 2003) The Office of the Attorney General, Crime Victims' Compensation Division collects information about individuals who complete and file this document with the Office of the Attorney General. Upon request, you are entitled to the fol- lowing: to be informed about the information collected; to receive and review the information; and to have the Office of the Attomey General correct information about you that is incorrect. • The offender, an accomplice, or person to whom an award would unjustly enrich the offender or accomplice. Please keep this page for your records. APPLICATION FORM For Texas Crime Victims' Compensation Benefits Si desea hablar con alguien en espanol, marque esta cajita por favor. ^ Espanol Please print clearly and use black ink, or type in the information. 0 VICTIM INFORMATION The VICTIM is the person who was injured or killed as a result of the crime. !f the victim is a minor, you must also frll out the CLAIMANT INFORMATION section below. If there is more than one victim, each victim must have a separate application. VICTIM'S Last Name____-_____________-__First Name__-_--______-___-__Middle Name___-_-__ Street Address___________________________Apt. #_____-City________________State/Zip_____________ ------- Mailing Address______________________-______________City________________State/Zi p------------------- Home phone (---- )---------------------------------Work phone (-----) - ------------------------- Social Security Number __________-_________ ___-_____ Date of Birth ______ ~~x !~`~~ck one) OMale OFemale What kind of assistance do you need? Check all that apply. O Loss of Earnings O Loss of Support O Counseling O Funeral/Burial O Relocation OCrime-Related Travel O Child or Dependent Care O Crime Scene Clean-Up D Replacement of Property Seized as Evidence D Medical O Other ________________ ----------------------------------------------------------------------------------- ® CLAIMANT INFORMATION The CLAIMANT is a person, other than the victim, who had expenses as a direct result of the crime, or an immediate fam- ily member of the victim who requires counseling as a result of the crime, or who has legal authority to act on behalf of the victim. In order to contact CVC and discuss the claim, a caller must be on the application as a victim or claimant. CLAIMANT'S Last Name____________-_______First Name_______________________Middle Name_____________ Street Address----------------------------Apt. #____--City----------____--State/Zip--------------____-- Mailing Address------------------------------____--City--------------StatelZip_______________-- Home phone (---- )-----------------------------------Work phone (-----) ---- ----------------------- Social Security Number __________-_________-______-__ Date of Birth ______-____/___________/__ Relationship to Victim_____________________________ -------------------------------------------------- Sex (check one) OMale OFemale What kind of assistance do you need? Check all that apply. D Loss of Earnings D Loss of Support O Counseling O Funeral/Burial O Relocation OCrime-Related Travel O Child or Dependent Care D Crime Scen° Clean-Up O Replacement of Property Seized as Evidence D Medical D Other - ---- ----------- CLAIMANT'S Last Name First Street Address____________--________-_Apt. #__ Mailing Address__________-__________-______-- Home phone (-__ )_ Social Security Number _______-_-_________-______ Relationship to Victim___-_____________________ Sex (check one) OMale OFemale -----------------------Middle Name-----------• City---------------State/Z i P------------- C ity--------------State/Zip----------------- ---Work phone (-----) ------------------------- Date of Birth / / What kind of assistance do you need? Check all that apply. D Loss of Earnings D Loss of Support O Counseling O Funeral/Burial D Relocation DCrime-Related Travel D Child or Dependent Care O Crime Scene Clean-Up D Replacement of Property Seized as Evidence O Medical O Other See next page to enter more information. NOTE: If there are more than three 3 claimants, Please list them on a separate sheet of paper. RETURN THIS PAGE TO OFFICE OFT ATTORNEY GENERAL CLAIMANT'S Last Name First Na Street Address__-_-_-- __-_Apt. #____ Mailing Address-___--_-_--_----_-_ Home phone (___ }--_---- ___-__ Social Security Number __------ -_--- Relationship to Victim--- --__-__-_-_ Sex (check one) OMale OFemale '--------------- --Middle Name------------- City____- _ State/Zip__________________ .City----------State/Zi P----------------- __Work phone (__-_ } __ ----------- Date of Birth _-___ _/_-____-_/____ What kind of assistance do you need? Check all that apply. O Loss of Earnings O Loss of Support O Counseling O Funeral/Burial D Relocation OCrime-Related Travel O Child or Dependent Care O Crime Scene Clean-Up D Replacement of Property Seized as Evidence O Medical O Other __._ r_ ..~_..._._ _. ... _.~. ~. C1VIL~[AWSUIT &~ATTQRNEI(~1NFORMATION ~- ~ : ~~ _ ~`~~~ "" '' Have you filed a civil lawsuit in relation to this crime? (circle one) Yes No Do you plan on filing a civil lawsuit in relation to this crime? (circle one) Yes No What is your Attorney's name? What is your Attomey's phone number? Attorney's Address -_--__ ~:._ , ...._. .. o. City State/Zip INFORMATION ABOUT THE CRIME Complete this section with as many details as you have available. You must complete this section or your claim will not be processed. On what date did the Crime occur? ---------------- What is the Police Report Number (if known)?___ -------------------- What is the Child Protective Service Number (if known)?_____-_- - -- -------------------- What is the Prosecutor Case Number (if known)?___- -------------- What was the location of the crime? City _____ ___State/Zip_______________________County What is the name of the law enforcement agency that was notified? __ __~-____ Did the victim know the suspect? (circle one) Yes No If yes, how did the victim know the suspect? _________ What is the suspects name? _--_--_-___-__ _-__--____ What is the suspects social security number (if known)?--_ - ~-_-- Describe the crime and the injuries, if there were any. Have you ever filed charges against the suspect? (circle one) Yes No If this is a family violence crime, have you obtained a permanent protective order? (circle one) Yes No Court number Effective date What kind of crime occurred? Check all that best describes the type of crime that occurred. D Adult Sexual Assault O Child Sexual Assault O Child Physical Abuse O Assault (Non-Family) O Aggravated Assault D Family Violence D DWINehicular Crime O Elder Abuse O Homicide O Stalking D Kidnaping O Other (please specify)-_ RETURN THIS PAGE TO OFFICE OF THE ATTORNEY GENERAL -- r,.VICTIM EMPLOYMENT &~MEDICAL INt=~RMATION Was the victim employed on the date of the crime? (circle one) Yes No Was the victim se{f•emp{oyed on the date of the crime? (circle one) Yes No Occupation---___-._.__ __-_ _--_--_.Job Title___---_--__ What was the name of the victim's employer on the date ofi the crime? _--___._--__ Employer's Address -_____ _---_--_City__-_--_- -_State/Zip__. Phone (-.--) ------ -------_-_ Fax (--) -- - - If the victim has physical injuries, please provide the name of the treating doctor. Doctor's name--- ------------------- ------------------- Phone (----) ------------------ Fax { --- } ---- ------ -------- .. . 0.~,....9~„,~,_,,~.~:SIN,SURANCENDRE1MBURSEMENT=$OURCES~~~ _ ; . - . x .~ ., By law, you must first use all existing sources of financial assistance or reimbursement before receiving payments from the Crime Victims' Compensation Fund. Crime Victims' Compensation must first verify application to these sources and the amount received, if any, before determining reimbursement. Does the victim or the claimant have access to any of the following? (check all that apply). DMedicare OMedicaid OHeatth Insurance DBUrla) insurance DWorkers Compensation DAuto Insurance OHome Insurance C~Disability Insurance OSocia{ Security OVeteran's Benefits OOther What is the Medicare Numbef? ___,_______^.~~_-What is the Medicaid Number? What is the name of the Health tnsurance Company? _____________-___________- Health Insurance Co. Street Address____-_-______.______City____________________State/Zip______________ Group Policy Number ------------------------------------------------------------------------- If the crime was motor vehicle related, include the name of the auto insurance company and the policy numbers for both the victim and the suspect, if available. Victim's Auto Insurance Company name____--_-_-___-___-____________Policy number _____________ Suspect's Auto Insurance Company name__-____-_--___________-_______Policy number ________--___ - -. .._. ® , ; DEPARTMENT OF JUSTfCE INFORMATION `~, ~~ In order to comply with regulations from the United States Department of Justice, we must collect the following informa- tion about the victim of the crime. This information is for statistical purposes only. 1t will not be used in determining whether the victim is elioibte for Crime Victims' Compensation benefits Was the victim disabled at the time of the crime? (circle one) Yes ivo To which ethnic group does the victim belong? (check one ) OAmerican Indian or Alaskan Native DBlack OHispanic OWhite DASIan or Pacific Islander What is their National Origin (Country of Birth}? Where did you find out about the Crime Victims' Compensation Program? (check all that apply) OPublic Service Announcement OCompensation Program OAdvocacy Group OVictim Assistance Program OPoster OBrochure OHospitai OLaw Enforcement ^Other, RETURN THIS PAGE TO OFFICE OF THE ATTORNEY GENERAL IMPORTANT AFFIDAVIT ~..~ _. _ IMPORTANT: This affidavit is part of your application and must be completed and signed before action can be taken on the application. READ EVERYTHING BEFORE YOU SIGN AT THE BOTTOM. Subrogation Agreement. In accordance with Texas Code of Criminal Procedure, Article 56.52, I agree to notify the Crime Victims' Compensation Division (CVC) of the Office of the Attorney General in writing before I file a lawsuit against another party as a result of this crime. I further agree that I shall not settle or resolve any such action without prior written authorization from CVC. If 1 recover any money by judgment, settlement, or other collateral source as a result of the incident that gave rise to this claim, I agree to repay CVC for any and all amounts that CVC has awarded to me. 1 agree that Travis County, Texas will have jurisdiction over any cause of action that arises between me and the Office of the Attorney General as a result of this claim. Authorization for release of information, t hearby authorize any financial institution, social service agency, government agency, hospital, physician, mental health facility, counselor, psychologist, psychiatrist, employer, insurer, or other persons with informa- tion relating to financial, health, or employment status to release information concerning this application for benefits to the employees of the Crime Victims' Compensation Division of the Office of the Attorney General of Texas as needed to process this claim. This information is to include, but is not limited to, financial, employment, diagnosis, and treatment information. A copy of this signed release will be considered the same as the original. Affirmation and Authorization. I swear and affirm under penalty of perjury under the laws of the Stage or Texas (Penal Code § 37.02) that the information provided in the application for Texas Crime Vict~~i~s' Compensati~~~ and any additional information that t provide are true and correct to the best of my knowledge. ~ understand that the Attorney General of the State of Texas or any agent or representative of the office has the right to verify the information provided. 1 understand that if false, intentionally incomplete, or misleading information is provided, my appli~atiun will be denied and I may be subject to criminal punishment under the Texas Penal Code and administrative penalties under the Texas Code of Criminal Procedure, Chapter 56. VICTIM OR CLAIMANT MUST SIGN BELOW IN ORDER TO PROCESS THIS APPLICATION NOTE: You must be eighteen years of age or older to sign this application, unless you are legally married or emancipated. By signing this application, the victim or claimant has indicated an intent to make confidential his or her identifying infor- mation. Please note that Section 552.132 of the Texas Public Information Act only provides confidentiality for the identity of victims, as defined by Subchapter B, Chapter 56 of the Code of Criminal Procedure. If a victim or claimant wishes to make his or her identifying information public, please state your request here O Yes O No Signature_X--------------------------------------------------------- ----- Printed Name---------------------------- ---------------Da+=---------- Date of Birth Victini'~ SS# IF THE VICTIM CANNOT SIGN THE APPLICATION (MINOR OR INCAPACITATED ADULTI THE CLAIMANT MUST SIGN HERE IN ORDER TO PROCES THIS APPLICATION. Signature Printed Name-~[i-----------------------------------------Date--- --------- Date of Birth Claimant's SS # If someone helped you fill out this application, list his or her name and phone number here. RETURN THIS PAGE TO OFFICE OF THE ATTORNEY GENERAL Crime Victims' Compensation (011) • P.O. Box 12198 • Austin, Texas 78711-2198 Revised 02103