BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 681
                                                                  Page  1

          Date of Hearing:   April 2, 2013
          Chief Counsel:      Gregory Pagan


                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY
                                 Tom Ammiano, Chair

                AB 681 (Melendez) - As Introduced:  February 21, 2013
                       As Proposed to be Amended in Committee


           SUMMARY  :  Increases from $3 to $5 the fee charged for each  
          inmate-initiated medical visit of an inmate confined in a county  
          or city jail.

           EXISTING LAW  :

          1)Provides that a sheriff, director of corrections, or chief of  
            police is authorized to charge a fee in the amount of $3 for  
            each inmate initiated medical visit of an inmate confined in a  
            county or city jail.  [Penal Code Section 4011.2(a).]

          2)States that the fee shall be charged to the inmate's personal  
            account at the facility.  If the inmate has no money in his or  
            her personal account, there shall be no charge for the medical  
            visit.  [Penal Code Section 4011.2(b).]

          3)Provides that an inmate shall not be denied medical care  
            because of a lack of funds in his or her personal account.   
            [Penal Code Section 4011.2 (c).]

          4)Provides that the medical provider may waive the fee for any  
            inmate-initiated treatment and shall waive the fee for any  
            life-threatening or emergency situation, defined as those  
            health services required for alleviation of severe pain or for  
            immediate diagnosis and treatment of unforeseen medical  
            conditions that if not immediately treated could lead to  
            disability or death.  [Penal Code Section 4011.2(d).]

          5)States that follow-up medical visits, at the direction of the  
            medical staff, shall not be charged to the inmate.  [Penal  
            Code Section 4011.2(e).]

          6)Provides that the Director of the Department of Corrections is  
            authorized to charge a fee in the amount of $5 for each inmate  








                                                                  AB 681
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            initiated medical visit of an inmate confined in the state  
            prison.  [Penal Code Section 5007.5(a).]

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           1)Authors Statement  :  According to the author, "A sheriff,  
            director of corrections, or chief of police is authorized to  
            charge a fee in the amount of $3 for each inmate co-pay in a  
            county or city jail.  This amount was set in 1994 and has not  
            been increased since.    Since the cost of a medical visit for  
            a county inmate is so low it causes some inmates to abuse the  
            system, for example, some common reasons to seek a non-medical  
            visit are drug seeking, wanting to see a specific person,  
            wanting to get out of his/her cell, and now with overcrowding  
            some inmates just want to have some privacy.  AB 681 will  
            increase the co-pay which will better align the amount charged  
            to them with the cost of care while deterring unnecessary and  
            frivolous use of medical services."

           2)California Department of Corrections and Rehabilitation (CDCR)  
            Medical Co-pay  :   Under existing law [Penal Code Section  
            5007.5(a)], the CDCR Director is authorized to charge a fee in  
            the amount of $5 for each inmate initiated medical visit of an  
            inmate confined in the state prison.  This bill aligns the fee  
            charged for an inmate initiated medical visit in the county  
            jail with the $5 fee charged to an inmate confined in the  
            state prison.

           3)Argument in Support  :  The  California State Sheriffs'  
            Association  writes, "Current law authorizes a sheriff to  
            charge a fee in the amount of three dollars ($3) for each  
            inmate-initiated medical visit of an inmate confined in a  
            county or city jail.  The fee is charged to the inmate's  
            personal account at the facility and is based strictly on the  
            ability to pay.  If the inmate has no money in his or her  
            personal account, there is no charge for the medical visit nor  
            is an inmate denied medical care because of a lack of funds in  
            his or her personal account.  The $3 fee that is currently  
            charged for inmate-initiated medical visits has not been  
            increased since 1994.  Costs of providing services have  
            subsequently increased since this fee was enacted, yet the fee  
            has not been adjusted to keep in line with those costs."









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           4)Argument in Opposition  :  The  Friends Committee on Legislation  
            of California  argues, "Though $10 co-pays may seem  
            insignificant for most of us, county prisoners lack the means  
            to earn money during their incarceration.  We are concerned  
            that raising the feel will discourage legitimate medical  
            visits and could result in serious health consequences for  
            county prisoners and correctional staff.  Moreover, given the  
            higher prevalence of communicable diseases in jails, as  
            documented by the Centers for Disease Control and the National  
            Commission on Correctional Health Care, the general public  
            could be placed at risk.

          "Given the potential risks associated with increasing the cost  
            of health care, we believe this bill should be carefully  
            vetted with input from correctional and public health  
            professionals.  Any fiscal savings resulting from increased  
            co-pays should be weighed against the potential health  
            consequences that could result in the need for more intensive  
            and widespread medical care."

           5)Prior Legislation  :

             a)   AB 2296 (Valadao), of the 2011-12 Legislative Session,  
               would have increased from $3 to $5 the fee charged for each  
               inmate-initiated medical visit by an inmate confined in a  
               county or city jail.  AB 2296 failed passage in the Senate  
               Public Safety Committee.

             b)   AB 1487 (Hill), of the 2009-10 Legislative Session,  
               would have increased from $3 to $6 the fee charged for each  
               inmate-initiated medical visit by an inmate confined in a  
               county or city jail, and required that the $3 fee increase  
               be deposited in the county inmate welfare fund.  AB 1487  
               was amended in the Senate into an unrelated subject area.

             c)   AB 2232 (Nielsen), of the 2009-10 Legislative Session,  
               would have required that a $5 fee be charged by the  
               California Department of Corrections for each  
               inmate-initiated medical visit of an inmate confined in the  
               state prison, extended the fee to dental visits, and  
               required that inmates be charged for medically directed  
               follow up visits.  AB 2232 was never heard by this  
               Committee.

           REGISTERED SUPPORT / OPPOSITION  :   








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           Support 

           California State Sheriffs' Association
          Peace Officers Research Association
          Rural County Representatives of California 
          San Bernardino County Sheriff's Department

           Opposition 
           
          American Civil Liberties Union
          California Attorneys for Criminal Justice
          California Public Defenders Association
          Friends Committee on Legislation of California
          Legal Services for Prisoners with Children
           

          Analysis Prepared by  :    Gregory Pagan / PUB. S. / (916)  
          319-3744