BILL ANALYSIS Ó 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 Page 2 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." AB 681 Page 3 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 : AB 681 Page 4 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