BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 1433 (Mitchell) - Incarcerated persons: contraceptive
counseling and services
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|Version: April 7, 2016 |Policy Vote: PUB. S. 5 - 1 |
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|Urgency: No |Mandate: Yes |
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|Hearing Date: May 2, 2016 |Consultant: Jolie Onodera |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: SB 1433 would provide specified incarcerated persons
in state prisons or local detention facilities with access to
contraceptive counseling services and birth control, as
specified.
Fiscal
Impact:
State prisons : Future annual costs potentially in the range
of $630,000 to in excess of $1 million (General Fund) for the
California Correctional Health Care Services (CCHCS) to
provide the counseling services and methods of birth control.
Annual costs would fluctuate based on the inmate population
trends and volume of requests for services and materials. The
estimated costs assume 50 percent to 75 percent of eligible
female inmates of reproductive age will be served. The 2016-17
Governor's Budget includes funding of $632,000 for these
services. To the extent the posting of information required by
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this bill results in greater awareness and participation, and
the provision of services is not restricted to female inmates,
future costs could increase significantly above the budgeted
amount.
Local detention facilities : Major costs potentially in the
millions of dollars statewide, potentially state-reimbursable
(General Fund) to provide detainees in local detention
facilities, including county jails, with access to
contraceptive counseling and the birth control method of their
choice. For county jails alone, the latest Jail Profile Survey
(April-June 2015) indicates an average daily population of
over 9,600 females, and the provisions of this bill are not
specifically restricted to females. Staff notes any increase
in overall costs to local jails could potentially be subject
to the provisions of Proposition 30* in lieu of mandate
reimbursement.
Proposition 30 : Exempts the State from mandate reimbursement
for realigned responsibilities for "public safety services"
including the managing of local jails and the provision of
treatment, services and supervision of juvenile and adult
offenders. However, legislation enacted after September 30,
2012, that has an overall effect of increasing the costs
already borne by a local agency for public safety services
apply to local agencies only to the extent that the State
provides annual funding for the cost increase. The provisions
of Proposition 30 have not been interpreted through the formal
court process to date, however, to the extent the local agency
costs resulting from this measure are determined to be
applicable under the provisions of Proposition 30, local
agencies would not be obligated to provide the level of
service required by the bill above the level for which funding
is provided by the State.
Background: Existing law provides that any female confined in a local
detention facility or state prison be allowed to continue to use
materials necessary for personal hygiene with regard to her
menstrual cycle and reproductive system, as well as birth
control measures as prescribed by her physician. Additionally,
each female confined is to be furnished with information and
education regarding the availability of family planning
services. (Penal Code §§ 3409, 4023.5.)
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The CCHCS recently established a Women's Health Care Initiative
that is responsible for ensuring that the health care of
incarcerated female patients meets community standards. Among
other findings, it was determined that family planning services
at the California Institution for Women, the Central California
Women's Facility, and the newly established Folsom Women's
Facility needed enhancements in this area. As a result, the
pharmaceutical budget proposed in the 2016-17 Governor's Budget
includes $632,000 in funding for birth control and contraception
services for female patients who would benefit from their use.
Effective use of family planning services will help to reduce
the risks of unwanted pregnancies as a result of conjugal
visits, as well as provide services for women nearing parole who
are seeking assistance.
This bill seeks to codify the services provided in the 2016-17
Governor's Budget and thereby make access to these services
permanent. This bill additionally extends access to these
services to incarcerated females in local detention facilities.
Proposed Law:
This bill would require any incarcerated person in state prison
or a local detention facility who menstruates to, upon request,
have access and be allowed to use materials necessary for
personal hygiene with regard to their menstrual cycle and
reproductive system. Additionally, this bill:
Requires any incarcerated person who is capable of
becoming pregnant to, upon request, have access and be
allowed to obtain contraceptive counseling and their choice
of birth control methods, as specified, unless medically
contraindicated.
Provides that all birth control methods and emergency
contraception approved by the United States Food and Drug
Administration (FDA) shall be made available to
incarcerated persons who are capable of becoming pregnant,
with the exception of sterilizing procedures prohibited
under existing law.
Requires the CCHCS or the local detention facility to
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establish a formulary consisting of all FDA-approved birth
control methods that shall be available to incarcerated
persons. If a birth control method has more than one
FDA-approved therapeutic equivalent, only one version of
that method is required to be made available, unless
another version is specifically indicated by a prescribing
provider and approved by the chief medical physician at the
institution. Specifies that persons shall have access to
nonprescription birth control methods without the
requirement to see a licensed health care provider.
Provides that any contraceptive service that requires a
prescription, or any contraceptive counseling, provided to
incarcerated persons who are capable of becoming pregnant
provided, shall be furnished by a licensed health care
provider who has been provided training in reproductive
health care and shall be nondirective, unbiased, and
noncoercive. These services shall be furnished by the
facility or by any other agency which contracts with the
facility.
Requires health care providers furnishing contraceptive
services to receive training in the following areas:
o The requirements of this section.
o Providing nondirective, unbiased, and
noncoercive contraceptive counseling and services.
Exempts from the training above any providers who attend
an orientation program for the Family Planning, Access,
Care, and Treatment Program.
Requires any incarcerated person who is capable of
becoming pregnant to be furnished by the facility with
information and education regarding the availability of
family planning services and their right to receive
contraceptive counseling and services. Requires each
facility to post this information in conspicuous places to
which all incarcerated persons who are capable of becoming
pregnant have access.
Requires contraceptive counseling and family planning
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services to be offered and made available to all
incarcerated persons who are capable of becoming pregnant
at least 60 days, but not longer than 180 days, prior to a
scheduled release date.
Defines "local detention facility" to mean any city,
county, or regional facility used for the confinement of a
person for more than 24 hours.
Repeals existing PC §§ 3409 and 4023.5.
Staff
Comments: The 2016-17 Governor's Budget includes $632,000
(General Fund) to support the provision of contraceptive
counseling and birth control materials to inmates in state
facilities. This funding level is estimated to support
approximately 1,900 female inmates, which represents 50 percent
of the female inmate population that is of reproductive age. The
estimated future annual costs to serve inmates in state
facilities would be dependent on the population trends for
inmates in state prisons, the number of inmates electing to
receive services and materials, and the cost to provide these
services and medications. To the extent the eligible population
remains fairly constant, annual costs would potentially increase
above the budgeted amount both due to higher participation
resulting from greater awareness of the availability of these
services, as well as the potential for the cost of services and
medications to increase over time.
As indicated in the Fiscal Impact section of this analysis, this
bill creates a significant mandate on local detention facilities
to provide specified services and materials, as well as requires
the establishment of a formulary and training. While the fiscal
impact cannot be estimated with certainty and would vary widely
by county, the potential impacts are substantial given the
number of local detention facilities that would be required to
have this process in place. Staff notes the provisions of these
services could potentially result in major future cost savings
to the extent more positive long-term health outcomes result.
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