BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 966 (Bonta) - Prisoner Protections for Family and Community  
          Health Act.
          
          Amended: January 6, 2014        Policy Vote: Public Safety 5-1
          Urgency: No                     Mandate: No
          Hearing Date: June 23, 2014                             
          Consultant: Jolie Onodera       
          
          This bill meets the criteria for referral to the Suspense File.


          Bill Summary: AB 966 requires the Department of Corrections and  
          Rehabilitation (CDCR) to develop a five-year plan to expand the  
          availability of condoms in California prisons, based on CDCR's  
          2011 report recommendations and the pilot program conducted at  
          Solano State Prison.

          Fiscal Impact: 
              Minor, absorbable one-time costs (General Fund) to develop  
              the five-year plan.
              Potential future cost pressure of about $175,000 (General  
              Fund) to implement a statewide program. While the bill does  
              not require plan implementation, to the extent CDCR chooses  
              to do so, based on reported data from the pilot project,  
              potential first-year costs for a statewide program would  
              cost approximately $175,000 based on a cost per inmate of  
              $1.50 in the first year, including the initial cost of the  
              dispensers, decreasing to $90,000 statewide, based on a cost  
              of $0.76 per inmate for subsequent years. To the extent the  
              plan imposes a phased-in approach to implementation, initial  
              costs could be less. 
              Potential out-year significant savings in medical-related  
              costs to the CDCR and community at large to the extent the  
              plan is implemented and the availability of condoms results  
              in fewer cases of HIV/AIDS. It is estimated that very few  
              HIV infections (less than four cases) would need to be  
              prevented for a cost-neutral program.

          Background: Existing law declares that the spread of HIV/AIDS  
          within prison and jail populations presents a grave danger to  
          inmates within those populations, law enforcement personnel, and  
          other persons in contact with a prisoner infected with the AIDS  








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          virus, both during and after the prisoner's confinement (PC §  
          7500). According to 2013 data from the California Correctional  
          Health Care Services (CCHCS), there were 1,055 inmates infected  
          and receiving treatment for HIV/AIDS in California's prisons.  
          Based on the average annual cost of care of $29,500 (including  
          medication and laboratory tests, but exclusive of clinical staff  
          and additional diagnostic studies), the annual cost to treat  
          these inmates is estimated at over $31 million.

          State regulations prohibit all sex acts, illegal and consensual,  
          between inmates (Title 15, California Code of Regulations §  
          3007). Existing law provides that any person who participates in  
          an act of sodomy with any person of any age while confined in  
          any state prison or local detention facility shall be punished  
          by imprisonment in state prison or county jail for up to one  
          year (PC § 286(e)). In addition, any person participating in an  
          act of oral copulation while confined in any state prison or  
          local detention facility shall be punished by imprisonment in  
          the state prison or county jail for up to one year (PC §  
          288a(e)).

          AB 1334 (Swanson) 2008 would have required the CDCR to allow  
          nonprofit and health care agencies to enter prisons to provide  
          sexual barrier protection devices, including condoms. The  
          Governor's veto message noted that although it is unlawful to  
          engage in sexual activity while incarcerated, condom  
          distribution in prison is "not an unreasonable public policy and  
          is consistent with the need to improve our prison health care  
          system and overall public health."

          Additionally, the Governor's veto message directed the CDCR to  
          determine the risk and viability of such a program by  
          identifying one state prison facility for the purpose of a pilot  
          program. As a result, a pilot program was implemented in Solano  
          State Prison for one year from November 5, 2008, through  
          November 4, 2009. Several agencies covered all costs for the  
          program and volunteered staff time and expertise. The Center for  
          Health Justice, a nonprofit organization, purchased the condom  
          dispensing machines and condoms, monitored and refilled the  
          dispensers throughout the pilot period, and provided education  
          for staff and inmates.

          Various researchers from the Division of Correctional Health  
          Care Services and the State Department of Public Health provided  








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          evaluation services and finalized their conclusions in a  
          September 2011 report entitled, "Evaluation of a Prisoner Condom  
          Access Pilot Program Conducted in One California State Prison  
          Facility." The report concluded that there was no evidence that  
          providing condoms posed an increased risk to safety or security,  
          or resulted in injury to staff or inmates in a general  
          population prison facility setting. The report concluded that  
          providing condoms from dispensing machines is feasible and of  
          relatively low cost to implement and maintain. Finally, the  
          report concluded that providing condoms would likely reduce the  
          transmission of HIV, sexually transmitted diseases, and  
          hepatitis in CDCR prisons, thereby reducing medical costs to  
          both the CDCR and the community.

          Proposed Law: This bill requires the CDCR to develop a five-year  
          plan to expand the availability of condoms in all California  
          prisons based on the recommendations contained in the  
          "Evaluation of a Prisoner Condom Access Pilot Program Conducted  
          in One California State Prison Facility," report and in light of  
          the successful pilot project conducted at California State  
          Prison, Solano.

          Prior Legislation: AB 999 (Bonta) 2013 was similar to this  
          measure but required not only the development of a plan, but  
          also the implementation of the plan. This bill was vetoed by the  
          Governor with the following message:

          I am returning Assembly Bill 999 without my signature. This bill  
          would require the California Department of Corrections and  
          Rehabilitation to develop a plan to expand the availability of  
          condoms to all California prisons. The Department currently  
          allows family visitors to bring condoms for the purpose of the  
          family overnight visitation program. While expansion of the  
          program may be warranted, the Department should evaluate and  
          implement this expansion carefully and within its existing  
          authority.

          AB 1334 (Swanson) 2008 would have authorized any nonprofit or  
          health care agency to distribute sexual barrier protection  
          devices to inmates in state prisons. This bill was vetoed by the  
          Governor.

          AB 1677 (Koretz) 2006 was virtually identical to AB 1334. This  
          measure was vetoed by the Governor who stated the provisions of  








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          the bill were in conflict with the Penal Code.

          Staff Comments: This bill requires the CDCR to develop a  
          five-year plan based on  
          the recommendations contained in the specified report, but does  
          not require implementation of the plan. The costs to develop the  
          plan are estimated to be minor and absorbable given the volume  
          of available data from the report and pilot project.  

          While the bill does not require implementation of the plan, the  
          development of the plan does create cost pressure to eventually  
          do so. To the extent the CDCR does implement the plan at some  
          point in the future, based on reported data from the pilot  
          project, first-year costs for a statewide program would cost  
          approximately $175,000 based on a cost per inmate of $1.50 in  
          the first year (based on the inmate population of approximately  
          116,500 as of May 2014), including the initial cost of the  
          dispensers, decreasing to $90,000 statewide, based on a cost of  
          $0.76 per inmate for subsequent years. Should implementation of  
          the program be contingent upon sufficient donations for the  
          non-administrative costs of the program, including the  
          dispensers and condoms, first-year costs would be offset by the  
          level of donations. To the extent sufficient donations are not  
          received each year, the costs of the program would be borne by  
          the CDCR.

          To the extent the availability of condoms results in fewer cases  
          of HIV/AIDS within state prisons, the potential for out-year  
          savings in medical-related costs to the CDCR and the community  
          at large is significant. Based on the CCHCS annual cost of  
          inmate care for HIV of $29,500, it is estimated that very few  
          HIV infections (less than 4 cases) would need to be prevented  
          for a cost-neutral program.