BILL ANALYSIS Ó AB 1703 Page 1 Date of Hearing: March 1, 2016 Counsel: David Billingsley ASSEMBLY COMMITTEE ON PUBLIC SAFETY Bill Quirk, Chair AB 1703 (Santiago) - As Introduced January 25, 2016 SUMMARY: Expands the definition of "immediate medical or hospital care" to includes critical specialty medical procedures or treatment, such as dialysis, which cannot be performed at a city or county jail. EXISTING LAW: 1)Provides that whenever it appears to a sheriff or jailer that a prisoner in a jail under his or her charge is in need of immediate medical or hospital care, and that the health and welfare of the prisoner will be injuriously affected unless the prisoner is taken to a hospital, the sheriff or jailer may authorize the immediate removal of the prisoner under guard to a hospital, without first obtaining a court order as specified. (Pen. Code § 4011.5.) 2)Requires the sheriff or jailer to apply to a judge for an order authorizing the continued absence of the prisoner from the jail when the condition of the prisoner prevents his return to the jail within 48-hours from the time of his removal for medical treatment, (Pen. Code § 4011.5.) 3)Specifies that the court may order the removal of an inmate AB 1703 Page 2 from a city or county jail to the county hospital or if there is no county hospital in such county, to any hospital designated by such court when the judge finds that a prisoner in any city or county jail requires medical treatment necessitating hospitalization that cannot be provided at the jail. (Pen. Code § 4011, subd. (a).) 4)Requires the sheriff or other official in charge of county correctional facilities to maintain the necessary guards, who may be private security guards, for the safekeeping of a prisoner at an outside medical facility. (Pen. Code § 4011, subd. (a).) 5)Specifies that any case in which it appears to the person in charge of a jail, or juvenile detention facility, or to a judge, that a person in custody in that jail or juvenile detention facility may be mentally disordered, he or she may cause the prisoner to be taken to a facility for 72-hour treatment and evaluation and he or she shall inform the facility in writing, which shall be confidential, of the reasons that the person is being taken to the facility. (Pen. Code § 4011.6.) 6)Specifies that the cost of outside medical services will be charged against the county or the city responsible for the jail, and the city or county may recover the costs from the person receiving medical services, or any person or agency responsible for his care and maintenance. (Pen. Code § 4011, subd. (b).) 7)Provides that when a prisoner is poor, the cost of outside medical services will be paid out of the general fund of the city or county. (Pen. Code § 4011, subd. (c).) 8)States that in the case of city jail prisoners removed to the county hospital, the cost of such hospital care will be paid by the city to the county, at a rate per day fixed by the board of supervisors of the county to approximate the average actual cost to the county of such hospital care. (Pen. Code § 4011, subd. (c).) 9)Provides that a prisoner who is financially able to pay for AB 1703 Page 3 his medical care, the medical superintendent of such hospital other than a county hospital may, with the approval of a judge, enter into a special agreement with such person, or with his relatives or friends, for his medical expenses. (Pen. Code § 4011, subd. (d).) 10)States that any prisoner may decline care or treatment and provide other care and treatment for himself at his own expense. (Pen. Code § 4011, subd. (d).) FISCAL EFFECT: Unknown COMMENTS: 1)Author's Statement: According to the author, "Current law governing the medical treatment of prisoners in county or city jails was written prior to the passage of realignment, when the average stay was 30 days in county jail. Today, those convicted of a felony stay for much longer. This increases long-term medical issues faced by inmates along with the processes and procedures sheriffs and jailers must undergo to address them. "Los Angeles County jail runs anywhere from six to twelve inmates at a time, several times a week, to receive dialysis treatment. Los Angeles County sheriffs must obtain a court order for each individual to be transported to an outside medical facility. "This is time consuming, both for court and the jail. "Court orders prolong the process that sheriffs and jailers must undergo to remove an inmate for ongoing specialty treatments. This time consuming process results in backlog that delays treatment, which usually results in unintended expensive medical emergencies." 2)This Bill Seeks to Add Language to an Existing Statute as Clarification: Existing law allows a sheriff or a jailer to transport a prisoner to a hospital without a court order, when the prisoner is "in need or immediate medical or hospital care and that the health and welfare of the prisoner will be AB 1703 Page 4 injuriously affected unless the prisoner is taken to a hospital." (Pen. Code § 4011.5.) This bill does not seek to change that language. Rather, the bill adds language which clarifies that "critical specialty medical procedures or treatment, such as dialysis, which cannot be furnished, performed, or supplied at a city or county jail" are treatments which fall under the more general definition of immediate medical care. If such language serves as a clarification, it is only necessary to the extent that the current language is not being interpreted to include such medical procedures. 3)Longer Stays in County Jail Related to Realignment: Realignment limited which felons can be sent to state prison, thus requiring that more felons serve their sentences in county jails. Realignment applies to defendants who commit qualifying offenses, do not have specified prior convictions, and who were sentenced on or after October 1, 2011. One consequence of realignment was to shift some of the population serving time in the state prisons to county jails. The Public Policy Institute of California (PPIC) has studied the impact of realignment. PPIC has noted the impact of increased number of county jail inmates since Realignment: "Our data indicate that realignment has significantly affected county jail populations. Between June 2011 and June 2012, during which time California's prison population declined by roughly 26,600, the average daily population of California's jails grew by about 8,600 inmates, or about 12 percent."(Impact of Realignment on County Jail Populations, PPIC, Magnus Lofstrom and Louis Raphael, 2013, p. 2.) PPIC's research has specifically noted the number of inmates now serving extended sentences in county jails: Before realignment, the maximum stay in county jail was one year. Now that lower-level felons go to county jail, this practice has changed-there is no limit on the amount of time these offenders can serve. As of early 2014, county jails housed 1,761 inmates serving sentences of more than five years-up 606 from 2013. ( http://www.ppic.org/main/publication_show.asp?i=1061 ) AB 1703 Page 5 Given the significant number of inmates serving sentences in county jails in excess of a year, it is natural to expect a corresponding increase in health problems that need to be dealt with over multi-year county jail sentences. 4)Argument in Support: According to California State Association of Counties, "Current law allows a Sheriff to remove a prisoner in a county or a city jail if the prisoner needs on-going medical treatments, such as dialysis or hospital care. Each time an inmate is removed from a jail the sheriff is required to obtain a court order. This can be a very time consuming process that can result in backlogs that seriously delay treatment for inmates in need of critical care. "AB 1703 will expedite the transport process for these inmates by extending the definition of immediate medical care to include critical specialty medical procedures or treatment such as dialysis. This will result in one court order for the medical care of the inmate reducing the burden on the courts and law enforcement for repetitive court orders." 5)Prior Legislation: a) AB 2261 (Valdavao), of the 2011-2012 Legislative Session, would have allowed a $5 fee for each inmate initiated medical visit for inmates in city or county jail. AB 2261 was held in the Senate Public Safety Committee. b) AB 1487 (Hill), of the 2009-2010 Legislative Session, amended in the Senate into an unrelated subject area, 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. REGISTERED SUPPORT / OPPOSITION: Support Los Angeles County Sheriff's Office (Sponsor) AB 1703 Page 6 American Civil Liberties Union of California California State Association of Counties California State Sheriffs' Association Opposition None Analysis Prepared by: David Billingsley / PUB. S. / (916) 319-3744