BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON PUBLIC SAFETY
                             Senator Loni Hancock, Chair
                                2015 - 2016  Regular 

          Bill No:    SB 1443       Hearing Date:    April 12, 2016    
          
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          |Author:    |Galgiani                                             |
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          |Version:   |March 28, 2016                                       |
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          |Urgency:   |No                     |Fiscal:    |Yes              |
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          |Consultant:|JRD                                                  |
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                   Subject:  Incarcerated Persons:  Health Records



          HISTORY

          Source:   California Correctional Healthcare Services

          Prior Legislation:       None known

          Support:  Unknown

          Opposition:None known 

           
          PURPOSE

          The purpose of this legislation is to permit the sharing of  
          medical, mental health and dental information between  
          correctional facilities, as specified. 

          Under existing law a provider of health care, health care  
          service plan, or contractor  is prohibited from disclosing  
          medical information regarding a patient of the provider of  
          health care or an enrollee or subscriber of a health care  
          service plan without first obtaining an authorization, except:

               A provider of health care, a health care service plan, or  
              a contractor must disclose medical information if the  







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              disclosure is compelled by any of the following:

             o    By a court order.
             o    By a board, commission, or administrative agency for  
               purposes of adjudication pursuant to its lawful authority.
             o    By a party to a proceeding before a court or  
               administrative agency pursuant to a subpoena, subpoena  
               duces tecum, notice to appear served pursuant to Section  
               1987 of the Code of Civil Procedure, or any provision  
               authorizing discovery in a proceeding before a court or  
               administrative agency.
             o    By a board, commission, or administrative agency  
               pursuant to an investigative subpoena issued under Article  
               2 (commencing with Section 11180) of Chapter 2 of Part 1 of  
               Division 3 of Title 2 of the Government Code.
             o    By an arbitrator or arbitration panel, when arbitration  
               is lawfully requested by either party, pursuant to a  
               subpoena duces tecum issued under Section 1282.6 of the  
               Code of Civil Procedure, or another provision authorizing  
               discovery in a proceeding before an arbitrator or  
               arbitration panel.
             o    By a search warrant lawfully issued to a governmental  
               law enforcement agency.
             o    By the patient or the patient's representative pursuant  
               to Chapter 1 (commencing with Section 123100) of Part 1 of  
               Division 106 of the Health and Safety Code.
             o    By a coroner, as specified.
             o    When otherwise specifically required by law.

               A provider of health care or a health care service plan  
              may disclose medical information as follows:

             o    The information may be disclosed to providers of health  
               care, health care service plans, contractors, or other  
               health care professionals or facilities for purposes of  
               diagnosis or treatment of the patient, as specified.
             o    The information may be disclosed to an insurer,  
               employer, health care service plan, hospital service plan,  
               employee benefit plan, governmental authority, contractor,  
               or other person or entity responsible for paying for health  
               care services rendered to the patient, to the extent  
               necessary to allow responsibility for payment to be  
               determined and payment to be made, as specified. 
             o    The information may be disclosed to a person or entity  








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               that provides billing, claims management, medical data  
               processing, or other administrative services for providers  
               of health care or health care service plans or for any of  
               the persons or entities, as specified.
             o    The information may be disclosed to organized committees  
               and agents of professional societies or of medical staffs  
               of licensed hospitals, licensed health care service plans,  
               professional standards review organizations, independent  
               medical review organizations and their selected reviewers,  
               utilization and quality control peer review organizations  
               as established by Congress in Public Law 97-248 in 1982,  
               contractors, or persons or organizations insuring,  
               responsible for, or defending professional liability that a  
               provider may incur, if the committees, agents, health care  
               service plans, organizations, reviewers, contractors, or  
               persons are engaged in reviewing the competence or  
               qualifications of health care professionals or in reviewing  
               health care services with respect to medical necessity,  
               level of care, quality of care, or justification of  
               charges.
             o    The information in the possession of a provider of  
               health care or health care service plan may be reviewed by  
               a private or public body responsible for licensing or  
               accrediting the provider of health care or health care  
               service plan, as specified.
             o    The information may be disclosed to the county coroner  
               in the course of an investigation by the coroner's, as  
               specified.
             o    The information may be disclosed to public agencies,  
               clinical investigators, including investigators conducting  
               epidemiologic studies, health care research organizations,  
               and accredited public or private nonprofit educational or  
               health care institutions for bona fide research purposes,  
               as specified. 
             o    A provider of health care or health care service plan  
               that has created medical information as a result of  
               employment-related health care services to an employee  
               conducted at the specific prior written request and expense  
               of the employer may disclose to the employee's employer  
               that part of the information that:

                  §         Is relevant in a lawsuit, arbitration,  
                    grievance, or other claim or challenge to which the  
                    employer and the employee are parties and in which the  








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                    patient has placed in issue his or her medical  
                    history, mental or physical condition, or treatment,  
                    provided that information may only be used or  
                    disclosed in connection with that proceeding.
                  §         Describes functional limitations of the  
                    patient that may entitle the patient to leave from  
                    work for medical reasons or limit the patient's  
                    fitness to perform his or her present employment,  
                    provided that no statement of medical cause is  
                    included in the information disclosed.

             o    Unless the provider of health care or a health care  
               service plan is notified in writing of an agreement by the  
               sponsor, insurer, or administrator to the contrary, the  
               information may be disclosed to a sponsor, insurer, or  
               administrator of a group or individual insured or uninsured  
               plan or policy that the patient seeks coverage by or  
               benefits from, if the information was created by the  
               provider of health care or health care service plan as the  
               result of services conducted at the specific prior written  
               request and expense of the sponsor, insurer, or  
               administrator for the purpose of evaluating the application  
               for coverage or benefits.
             o    The information may be disclosed to a health care  
               service plan by providers of health care that contract with  
               the health care service plan and may be transferred among  
               providers of health care that contract with the health care  
               service plan, for the purpose of administering the health  
               care service plan, as specified.
             o    This part does not prevent the disclosure by a provider  
               of health care or a health care service plan to an  
               insurance institution, agent, or support organization,  
               subject to Article 6.6 (commencing with Section 791) of  
               Chapter 1 of Part 2 of Division 1 of the Insurance Code, of  
               medical information if the insurance institution, agent, or  
               support organization has complied with all of the specified  
               requirements for obtaining the information.
             o    The information relevant to the patient's condition,  
               care, and treatment provided may be disclosed to a probate  
               court investigator in the course of an investigation  
               required or authorized in a conservatorship proceeding  
               under the Guardianship-Conservatorship Law as defined in  
               Section 1400 of the Probate Code, or to a probate court  
               investigator, probation officer, or domestic relations  








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               investigator engaged in determining the need for an initial  
               guardianship or continuation of an existing guardianship.
             o    The information may be disclosed to an organ procurement  
               organization or a tissue bank processing the tissue of a  
               decedent for transplantation into the body of another  
               person, but only with respect to the donating decedent, for  
               the purpose of aiding the transplant. For the purpose of  
               this paragraph, "tissue bank" and "tissue" have the same  
               meanings as defined in Section 1635 of the Health and  
               Safety Code.
             o    The information may be disclosed when the disclosure is  
               otherwise specifically authorized by law, including, but  
               not limited to, the voluntary reporting, either directly or  
               indirectly, to the federal Food and Drug Administration of  
               adverse events related to drug products or medical device  
               problems, or to disclosures made pursuant to subdivisions  
               (b) and (c) of Section 11167 of the Penal Code by a person  
               making a report pursuant to Sections 11165.9 and 11166 of  
               the Penal Code, provided that those disclosures concern a  
               report made by that person.
             o    Basic information, including the patient's name, city of  
               residence, age, sex, and general condition, may be  
               disclosed to a state-recognized or federally recognized  
               disaster relief organization for the purpose of responding  
               to disaster welfare inquiries.
             o    The information may be disclosed to a third party for  
               purposes of encoding, encrypting, or otherwise anonymizing  
               data, as specified.
             o    For purposes of disease management programs and services  
               as defined in Section 1399.901 of the Health and Safety  
               Code, information may be disclosed, as specified.
             o    The information may be disclosed, as permitted by state  
               and federal law or regulation, to a local health department  
               for the purpose of preventing or controlling disease,  
               injury, or disability, including, but not limited to, the  
               reporting of disease, injury, vital events, including, but  
               not limited to, birth or death, and the conduct of public  
               health surveillance, public health investigations, and  
               public health interventions, as authorized or required by  
               state or federal law or regulation.
             o    The information may be disclosed, consistent with  
               applicable law and standards of ethical conduct, by a  
               psychotherapist, as defined in Section 1010 of the Evidence  
               Code, if the psychotherapist, in good faith, believes the  








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               disclosure is necessary to prevent or lessen a serious and  
               imminent threat to the health or safety of a reasonably  
               foreseeable victim or victims, and the disclosure is made  
               to a person or persons reasonably able to prevent or lessen  
               the threat, including the target of the threat.
             o    The information may be disclosed as described in Section  
               56.103.
             o    The information may be disclosed to an employee welfare  
               benefit plan, to the extent that the employee welfare  
               benefit plan provides medical care, and may also be  
               disclosed to an entity contracting with the employee  
               welfare benefit plan for billing, claims management,  
               medical data processing, or other administrative services  
               related to the provision of medical care to persons  
               enrolled in the employee welfare benefit plan for health  
               care coverage, if all of the following conditions are met:

                  §         The disclosure is for the purpose of  
                    determining eligibility, coordinating benefits, or  
                    allowing the employee welfare benefit plan or the  
                    contracting entity to advocate on the behalf of a  
                    patient or enrollee with a provider, a health care  
                    service plan, or a state or federal regulatory agency.
                  §         The request for the information is accompanied  
                    by a written authorization for the release of the  
                    information submitted in a manner consistent with  
                    subdivision (a) and Section 56.11.
                  §         The disclosure is authorized by and made in a  
                    manner consistent with the Health Insurance  
                    Portability and Accountability Act of 1996 (Public Law  
                    104-191).
                  §         Any information disclosed is not further used  
                    or disclosed by the recipient in any way that would  
                    directly or indirectly violate this part or other  
                    specified restrictions.

             o    Information may be disclosed pursuant to subdivision (a)  
               of Section 15633.5 of the Welfare and Institutions Code by  
               a person required to make a report pursuant to Section  
               15630 of the Welfare and Institutions Code, provided that  
               the disclosure under subdivision (a) of Section 15633.5  
               concerns a report made by that person, as specified. 

          (Civil Code § 56.10.)








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          Existing law states that person sentenced to imprisonment in a  
          state prison or to imprisonment pursuant to subdivision (h) of  
          Section 1170 may during that period of confinement be deprived  
          of such rights, and only such rights, as is reasonably related  
          to legitimate penological interests, as specified.  (Penal Code  
          § 2600.)

          Existing law states that a person described in section 2600 must  
          have the following civil rights: 

               Except as provided in Section 2225 of the Civil Code, to  
              inherit, own, sell, or convey real or personal property,  
              including all written and artistic material produced or  
              created by the person during the period of imprisonment, as  
              specified. 
               To correspond, confidentially, with any member of the  
              State Bar or holder of public office, provided that the  
              prison authorities may open and inspect incoming mail to  
              search for contraband.
               To purchase, receive, and read any and all newspapers,  
              periodicals, and books accepted for distribution by the  
              United States Post Office. 

                  o         Pursuant to this section, prison authorities  
                    may exclude any of the following matter:

                       §              Obscene publications or writings,  
                         and mail containing information concerning where,  
                         how, or from whom this matter may be obtained.
                       §              Any matter of a character tending to  
                         incite murder, arson, riot, violent racism, or  
                         any other form of violence.
                       §              Any matter concerning gambling or a  
                         lottery.

                  o         Nothing in this section it to be construed as  
                    limiting the right of prison authorities to:

                       §              Open and inspect any and all  
                         packages received by an inmate.
                       §              Establish reasonable restrictions as  
                         to the number of newspapers, magazines, and books  
                         that the inmate may have in his or her cell or  








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                         elsewhere in the prison at one time.

               To initiate civil actions, subject to a three dollar ($3)  
              filing fee to be collected by the Department of Corrections  
              and Rehabilitation (CDCR), in addition to any other filing  
              fee authorized by law, and subject to Title 3a (commencing  
              with Section 391) of the Code of Civil Procedure.
               To marry.
               To create a power of appointment.
               To make a will.
               To receive all benefits provided for in Sections 3370 and  
              3371 of the Labor Code and in Section 5069.

          (Penal Code § 2601.)

          Under existing law, except as otherwise provided, an inmate who  
          is released on parole or postrelease supervision must be  
          returned to the county that was the last legal residence of the  
          inmate prior to his or her incarceration, as specified. Existing  
          law provides that, notwithstanding this provision, an inmate may  
          be returned to another county if that would be in the best  
          interests of the public (Penal Code § 3003(a)-(c).) 

          Existing law states in making its decision about an inmate who  
          participated in a joint venture program, the paroling authority  
          is required to give serious consideration to releasing him or  
          her to the county where the joint venture program employer is  
          located if that employer states to the paroling authority that  
          he or she intends to employ the inmate upon release.  (Penal  
          Code § 3003(d).) 

          Under existing law the following information, if available, must  
          be released by CDCR to local law enforcement agencies regarding  
          a paroled inmate or inmate placed on postrelease community  
          supervision, who is released in their jurisdictions:

               Last, first, and middle names.
               Birth date.
               Sex, race, height, weight, and hair and eye color.
               Date of parole or placement on postrelease community  
              supervision and discharge.
               Registration status, if the inmate is required to register  
              as a result of a controlled substance, sex, or arson  
              offense.








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               California Criminal Information Number, FBI number, social  
              security number, and driver's license number.
               County of commitment.
               A description of scars, marks, and tattoos on the inmate.
               Offense or offenses for which the inmate was convicted  
              that resulted in parole or postrelease community supervision  
              in this instance.
               Address, including all of the following information:

                  o         Street name and number. Post office box  
                    numbers are not acceptable for purposes of this  
                    subparagraph.
                  o         City and ZIP Code.
                  o         Date that the address provided pursuant to  
                    this subparagraph was proposed to be effective.

               Contact officer and unit, including all of the following  
              information:

                  o         Name and telephone number of each contact  
                    officer.
                  o         Contact unit type of each contact officer such  
                    as units responsible for parole, registration, or  
                    county probation.
                  o         A digitized image of the photograph and at  
                    least a single digit fingerprint of the parolee.
                  o         A geographic coordinate for the inmate's  
                    residence location for use with a Geographical  
                    Information System (GIS) or comparable computer  
                    program.

          (Penal Code § 3003(e)(1).) 

          Existing law states that unless the information is unavailable,  
          CDCR is required to electronically transmit to a county agency,  
          the inmate's tuberculosis status, specific medical, mental  
          health, and outpatient clinic needs, and any medical concerns or  
          disabilities for the county to consider as the offender  
          transitions onto postrelease community supervision, for the  
          purpose of identifying the medical and mental health needs of  
          the individual, as specified(Penal Code § 3003(e)(2)-(5).) 

          Existing law states that notwithstanding any other law, an  
          inmate who is released on parole cannot be returned to a  








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          location within 35 miles of the actual residence of a victim of,  
          or a witness to, a violent felony as defined in paragraphs (1)  
          to (7), inclusive, and paragraph (16) of subdivision (c) of  
          Section 667.5 or a felony in which the defendant inflicts great  
          bodily injury on a person other than an accomplice that has been  
          charged and proved as provided for in Section 12022.53, 12022.7,  
          or 12022.9, if the victim or witness has requested additional  
          distance in the placement of the inmate on parole, and if the  
          Board of Parole Hearings or CDCR finds that there is a need to  
          protect the life, safety, or well-being of a victim or witness.   
          (Penal Code § 3003(f).) 

          Existing law provides that notwithstanding any other law, an  
          inmate who is released on parole for a violation of Section 288  
          or 288.5 whom the CDCR determines poses a high risk to the  
          public shall not be placed or reside, for the duration of his or  
          her parole, within one-half mile of a public or private school  
          including any or all of kindergarten and grades 1 to 12,  
          inclusive.  (Penal Code § 3003(g).) 
          Existing law provides that notwithstanding any other law,, an  
          inmate who is released on parole or postrelease community  
          supervision for a stalking offense shall not be returned to a  
          location within 35 miles of the victim's actual residence or  
                                                                                 place of employment if the victim or witness has requested  
          additional distance in the placement of the inmate on parole or  
          postrelease community supervision, and if the Board of Parole  
          Hearings or the CDCR, or the supervising county agency, as  
          applicable, finds that there is a need to protect the life,  
          safety, or well-being of the victim. If an inmate who is  
          released on postrelease community supervision cannot be placed  
          in his or her county of last legal residence in compliance with  
          this subdivision, the supervising county agency may transfer the  
          inmate to another county upon approval of the receiving county.   
          (Penal Code § 3003(h).) 

          Existing law provides that an inmate may be paroled to another  
          state pursuant to any other law, as specified.   (Penal Code §  
          3003(j).) 

          Under existing law CDCR is the agency primarily responsible for,  
          and shall have control over, the program, resources, and staff  
          implementing the Law Enforcement Automated Data System (LEADS)  
          in conformance with subdivision (e). County agencies supervising  
          inmates released to postrelease community supervision pursuant  








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          to Title 2.05 (commencing with Section 3450) shall provide any  
          information requested by the department to ensure the  
          availability of accurate information regarding inmates released  
          from state prison. This information may include the issuance of  
          warrants, revocations, or the termination of postrelease  
          community supervision. On or before August 1, 2011, county  
          agencies designated to supervise inmates released to postrelease  
          community supervision shall notify the department that the  
          county agencies have been designated as the local entity  
          responsible for providing that supervision.  The Department of  
          Justice (DOJ) is the agency primarily responsible for the proper  
          release of information under LEADS that relates to fingerprint  
          cards. CDCR has to submit to the DOJ data to be included in the  
          supervised release file of the California Law Enforcement  
          Telecommunications System (CLETS) so that law enforcement can be  
          advised through CLETS of all persons on postrelease community  
          supervision and the county agency designated to provide  
          supervision. The data required by this subdivision shall be  
          provided via electronic transfer.  (Penal Code § 3003(k).) 

          This bill would authorize the disclosure of information between  
          a county correctional facility, a county medical facility, a  
          state correctional facility, or a state hospital to ensure the  
          continuity of health care of an inmate being transferred among  
          those facilities. The bill would also authorize the disclosure  
          and exchange of information by a county correctional facility, a  
          county medical facility, a state correctional facility, or a  
          state hospital to a contracted licensed mental health provider  
          performing a forensic evaluation of an offender or a mentally  
          disordered offender (MDO) or a sexually violent predator (SVP)  
          screening of an offender.

          This bill expressly states that an inmate's civil rights  
          include, subject to the bill's provisions relating to the  
          disclosure of medical information described above, all privacy  
          rights legally applicable to inmates.

          This bill would require, when jurisdiction of an inmate is  
          transferred from or among CDCR, the State Department of State  
          Hospitals, and county agencies caring for inmates, those  
          agencies to disclose, by electronic transmission when possible,  
          medical, dental, and mental health information regarding each  
          transferred or released inmate, as provided by the bill's  
          provisions. 








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          This bill would authorize the sharing of an inmate's health  
          information, as necessary for continuity of care, when an inmate  
          is transferred between or among a state prison, a fire camp  
          operated by CDCR, a state hospital, a county correctional  
          facility, or a county medical facility providing medical or  
          mental health services to offenders, as specified.

          This bill would require, when an inmate is being released by  
          CDCR to postrelease community supervision, or is being retained  
          in custody at a county or local jail, or county officials will  
          otherwise have responsibility for the inmate's ongoing health  
          care needs, the department to disclose the inmate's health  
          information, as necessary for continuity of care, to the  
          applicable county agency, as specified. 

          This bill would provide that the medical, dental, and mental  
          health information to be disclosed among CDCR, the State  
          Department of State Hospitals, and county agencies is limited to  
          the type and amount of information that is determined by  
          licensed medical providers, as a matter of general policy or on  
          a case-by-case basis, to be necessary for continuity of care or  
          to perform a mandatory offender screening, such as an MDO  
          screening or an SVP screening. The bill would authorize that  
          information to be disclosed either as already maintained in  
          existing medical records or as compiled for the purpose of the  
          disclosure, and would authorize that information to include,  
          among other things, medical history, physical information, and  
          public health information. 

          This bill would require all transmissions made pursuant to these  
          provisions to comply with specified provisions of state and  
          federal law, including, among others, the Confidentiality of  
          Medical Information Act.

                    RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION

          For the past several years this Committee has scrutinized  
          legislation referred to its jurisdiction for any potential  
          impact on prison overcrowding.  Mindful of the United States  
          Supreme Court ruling and federal court orders relating to the  
          state's ability to provide a constitutional level of health care  
          to its inmate population and the related issue of prison  
          overcrowding, this Committee has applied its "ROCA" policy as a  








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          content-neutral, provisional measure necessary to ensure that  
          the Legislature does not erode progress in reducing prison  
          overcrowding.   

          On February 10, 2014, the federal court ordered California to  
          reduce its in-state adult institution population to 137.5% of  
          design capacity by February 28, 2016, as follows:   

                 143% of design bed capacity by June 30, 2014;
                 141.5% of design bed capacity by February 28, 2015; and,
                 137.5% of design bed capacity by February 28, 2016. 

          In December of 2015 the administration reported that as "of  
          December 9, 2015, 112,510 inmates were housed in the State's 34  
          adult institutions, which amounts to 136.0% of design bed  
          capacity, and 5,264 inmates were housed in out-of-state  
          facilities.  The current population is 1,212 inmates below the  
          final court-ordered population benchmark of 137.5% of design bed  
          capacity, and has been under that benchmark since February  
          2015."  (Defendants' December 2015 Status Report in Response to  
          February 10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge  
          Court, Coleman v. Brown, Plata v. Brown (fn. omitted).)  One  
          year ago, 115,826 inmates were housed in the State's 34 adult  
          institutions, which amounted to 140.0% of design bed capacity,  
          and 8,864 inmates were housed in out-of-state facilities.   
          (Defendants' December 2014 Status Report in Response to February  
          10, 2014 Order, 2:90-cv-00520 KJM DAD PC, 3-Judge Court, Coleman  
          v. Brown, Plata v. Brown (fn. omitted).)  
           
          While significant gains have been made in reducing the prison  
          population, the state must stabilize these advances and  
          demonstrate to the federal court that California has in place  
          the "durable solution" to prison overcrowding "consistently  
          demanded" by the court.  (Opinion Re: Order Granting in Part and  
          Denying in Part Defendants' Request For Extension of December  
          31, 2013 Deadline, NO. 2:90-cv-0520 LKK DAD (PC), 3-Judge Court,  
          Coleman v. Brown, Plata v. Brown (2-10-14).  The Committee's  
          consideration of bills that may impact the prison population  
          therefore will be informed by the following questions:

              Whether a proposal erodes a measure which has contributed  
               to reducing the prison population;
              Whether a proposal addresses a major area of public safety  
               or criminal activity for which there is no other  








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               reasonable, appropriate remedy;
              Whether a proposal addresses a crime which is directly  
               dangerous to the physical safety of others for which there  
               is no other reasonably appropriate sanction; 
              Whether a proposal corrects a constitutional problem or  
               legislative drafting error; and
              Whether a proposal proposes penalties which are  
               proportionate, and cannot be achieved through any other  
               reasonably appropriate remedy.


          COMMENTS

          1.Need for This Legislation

          According to the author: 

               Currently, both state and county correctional facilities  
               receive medically and mentally unstable patients where the  
               patient's medical and/or mental health history at the time  
               of transfer is not provided.  Not only does this impact  
               offender safety, but it is costly as well, as many times  
               treatment/diagnostic testing must be duplicated at the  
               receiving facility.  Although there are a variety of  
               statutory schemes that discuss the transfer of patient  
               records in the public, none apply in a correctional  
               setting.

               This bill would address the current lack of statutory  
               authority that would provide for the transfer of medical  
               and mental health records for offenders who transition in  
               and out of various state and local jurisdictions.  This  
               bill would amend current law to require that an offender's  
               pertinent medical and mental health records and copies that  
               are reasonably available be transferred from the sending  
               practitioner to the receiving practitioner within 24 hours  
               whenever the offender transitions between state/county  
               correctional facilities.  The bill would allow for the  
               disclosure of medical or mental health information when an  
               offender is being transferred between state/county  
               correctional facilities, whether it be on a temporary or  
               permanent basis.
            
          2.CDCR Medical Care:  Federal Receivership 








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          The California Correctional Healthcare Services (CCHCS) (federal  
          receivership) was established as a result of a class action  
          lawsuit (Plata v. Brown) brought against the State of California  
          over the quality of medical care in the state's 34 adult  
          prisons. In its ruling, the federal court found that the care  
          was in violation of the Eighth Amendment of the U.S.  
          Constitution which prohibits cruel and unusual punishment. The  
          state settled the lawsuit and entered into a stipulated  
          settlement in 2002, agreeing to a range of remedies that would  
          bring prison medical care in line with constitutional standards.  
          The state failed to comply with the stipulated settlement and on  
          February 14, 2006, the federal court appointed a receiver to  
          manage medical care operations in the prison system. The current  
          receiver was appointed in January of 2008. The receivership  
          continues to be unprecedented in size and scope nationwide. 

          CCHCS is the sponsor of this legislation and states in support: 

               Currently, both state and county correctional facilities at  
               times receive medically and mentally unstable patients  
               where the patient's medical and/or mental health history at  
               the time of transfer is not included. Not only does this  
               impact offender safety, but it is costly as well, since  
               many times it may result in duplicate treatment/diagnostic  
               testing by the receiving facility. Although current law  
               offers a variety of statutory schemes discussing the  
               transfer of patient records for the public, none apply in a  
               correctional setting. 

               This bill would address the current lack of statutory  
               authority that would provide for the transfer of medical  
               and mental health records for offenders who transition in  
               and out of various state and local jurisdictions. This bill  
               would amend current law to require that an offender's  
               pertinent medical and mental health records and copies that  
               are reasonably available be transferred from the sending  
               practitioner to the receiving practitioner whenever the  
               offender transitions between state/county correctional  
               facilities. The bill would also authorize the disclosure of  
               this medical and/or mental health information under state  
               and federal health care privacy guidelines.

          3.Effect of this Legislation








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          This legislation is a double referral to the Judiciary  
          Committee, which will presumably examine the issues related to  
          the privacy of medical information.  From a public safety  
          perspective, improving the sharing of medial information will  
          almost certainly help to provide the inmate population with much  
          needed continuity of care.  

               Developing collaborative, intersectoral approaches to  
               address the high burden of disease among people involved in  
               the justice system is both a public health and public  
               safety imperative. People with serious mental illness are  
               significantly overrepresented in correctional systems. An  
               estimated 14.5 percent of men and 31 percent of women in  
               jails have a serious mental illness (SMI) such as  
               schizophrenia, major depression, and bipolar disorder,  
               compared to 5 percent of the general population. . . A lack  
               of health background information on the people involved in  
               the criminal justice system diminishes the likelihood that  
               jails will deliver properly targeted, often urgently needed  
               care. 

               (Bridging the Gap Improving the Health of Justice-Involved  
               People through Information Technology, February 2015, VERA  
               Institute of Justice, http://www.vera.org/sites  
               /default/files/resources/downloads/samhsa-justice-health-inf 
               ormation-technology.pdf.) 




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