BILL ANALYSIS Ó
AB 1703
Page 1
Date of Hearing: March 29, 2016
ASSEMBLY COMMITTEE ON HEALTH
Jim Wood, Chair
AB 1703
(Santiago) - As Introduced January 25, 2016
SUBJECT: Inmates: medical treatment.
SUMMARY: Expands the definition of immediate medical or
hospital care for inmates at county or city jails to include
critical specialty medical procedures, such as dialysis, which
cannot be furnished, performed, or supplied at a county or city
jail.
EXISTING LAW:
1)Allows a sheriff or jailer to authorize the immediate removal
of a prisoner under guard to a hospital, without first
obtaining a court order, if a sheriff or jailer believes that
the health and welfare of the prisoner will be injuriously
affected if the prisoner is not removed to a hospital.
2)Requires the sheriff or jailer to apply to a judge for a court
order authorizing the continued absence of the prisoner from
the jail, if the condition of the prisoner prevents their
return to the jail within 48 hours from the time of their
removal.
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3)Specifies the cost of such medical services and hospital care
and treatment be charged against the county or city, and that
the county or city may recover the same cost from the person
served, or any person or agency responsible for their care and
maintenance.
4)Allows any prisoner to decline such care or treatment and
provide other care and treatment at their own expense.
FISCAL EFFECT: None.
COMMENTS:
1)PURPOSE OF THIS BILL. According to the author, court orders
authorizing removal of an inmate for medical or surgical
treatment prolong the process that sheriffs and jailers must
undergo to remove an inmate for ongoing specialty treatments.
This time consuming process results in backlogs that delay
treatment, which usually results in unintended medical
emergencies.
2)BACKGROUND.
a) Public Safety Realignment. After decades of dramatic
prisoner population growth, California's state prisons
faced severe overcrowding in the 2000s. Lawsuits filed in
1991 and 2001 alleged inadequate mental health and medical
care, and federal courts appointed a special master and a
receiver to oversee these functions. In 2009, a federal
three-judge panel ordered the state to reduce the prison
population from close to 190% to 137.5% of design capacity,
the minimum level believed necessary for the prison system
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to provide adequate mental health and medical care. In
2011 the Legislature passed AB 109 (Committee on Budget),
Chapter 15, Statutes of 2011, known as public safety
realignment. AB 109 shifted incarceration and supervision
responsibility for many lower-level felons from the state
prison system to county sheriffs' and probation
departments, based on the idea that locals can do a better
job. Realignment changed the profile of county jail
populations. Before realignment, the maximum jail sentence
was one year. Now, the jail time convicted offenders serve
is often longer. According to the Public Policy Institute
of California, by early 2014, 1,761 jail inmates were
serving sentences of more than five years, up from 1,155 in
2013. Higher inmate populations, especially those serving
longer terms, increase demand for medical and mental health
beds and program and recreation space.
b) Dialysis. Dialysis is the treatment for end stage
kidney disease, which usually occurs when the kidneys have
lost about 85 to 90% of their function. When kidneys fail,
dialysis keeps the body in balance by removing waste, salt
and extra water to prevent them from building up in the
body; keeping a safe level of certain chemicals in the
blood, such as potassium, sodium and bicarbonate; and,
helping to control blood pressure. Kidney failure is
usually, but not always, permanent. In chronic or end
stage kidney failure, the kidneys do not get better and
patients need dialysis for the rest of their life.
According to the National Kidney Foundation, dialysis is
usually done three times per week for about four hours at a
time, and people who stop dialysis may live anywhere from
one week to several weeks, depending on the amount of
kidney function they have left and their overall medical
condition.
According to medical staff of the Los Angeles County
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Sheriff's Department (the sponsor of this bill) at any
given time they average six to 12 inmates who require
dialysis several times per week. They must get a court
order for each individual every time they take them to a
private contract dialysis center.
3)SUPPORT. The Los Angeles County Sheriff's Department is the
sponsor of this bill and notes that current law allows a
sheriff to remove a prisoner under his charge in a county jail
or a city jail, if the prisoner is in need of immediate
medical or hospital care, provided the health and welfare of
the prisoner will be injuriously affected if not transported
to a hospital. The sponsor states this bill will change the
definition of immediate medical or hospital care to include
critical specialty medical procedures or treatment such as
dialysis, which cannot be furnished, performed, or supplied at
such county jail or city jail, ensuring inmates receive timely
treatment for their on-going critical medical needs.
The American Civil Liberties Union of California states this
is an important bill that seeks to ensure that individuals who
are detained in jails are able to access critical specialty
medical procedures and treatment without adverse delay and
without undue burden to the courts.
The California State Association of Counties supports this
bill, writing that it 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, which 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.
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4)PREVIOUS LEGISLATION. AB 2261 (Valadao) of 2012 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.
5)DOUBLE REFERRAL. This bill is double referred; it passed out
of the Assembly Public Safety Committee on March 1, 2016 with
a vote of 7-0.
6)POLICY COMMENT. Existing law allows a sheriff or a jailer to
transport a prisoner to a hospital without a court order, when
it appears the prisoner is "in need of immediate medical or
hospital care, and that the health and welfare of the prisoner
will be injuriously affected unless he is forthwith removed to
a hospital..." It could be argued that the need for dialysis
should and does qualify as needing immediate medical or
hospital care, and a court order should not be necessary.
However, some county counsel interpret the law to require a
court order to remove a prisoner for treatment unless it is an
emergency, hence this bill.
REGISTERED SUPPORT / OPPOSITION:
Support
Los Angeles County Sheriff's Department (sponsor)
American Civil Liberties Union of California
California State Association of Counties
California State Sheriffs' Association
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California Peace Officers Association
Urban Counties of California
Opposition
None on file.
Analysis Prepared by:Lara Flynn / HEALTH / (916) 319-2097