BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 1703


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          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  








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            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  








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            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  








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            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  )








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            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)








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          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