BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1900
                                                                  Page 1

          Date of Hearing:   April 6, 2010
          Counsel:                Meghan Masera


                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY
                                 Tom Ammiano, Chair

                AB 1900 (Skinner) - As Introduced:  February 16, 2010
           
           
           SUMMARY  :   Requires that inmates and wards in the custody of the  
          Department of Corrections and Rehabilitation (CDCR), CDCR's  
          Division of Juvenile Facilities, and local correctional and  
          juvenile facilities, who are known or suspected to be pregnant  
          be restrained in the least restrictive way possible, consistent  
          with the legitimate security needs of each inmate or ward, when  
          transported to and from their respective facilities.   
          Specifically,  this bill  :  

          1)Requires that, by January 1, 2012, the Corrections Standards  
            Authority (CSA) establish minimum standards for female inmates  
            at state and local correctional facilities to ensure that  
            inmates who are pregnant are restrained in the least  
            restrictive way possible, consistent with the legitimate  
            security needs of each inmate, when being transported.  In  
            addition, this bill mandates CSA to seek the advice of  
            Correctional Medical Associates and the Academy of  
            Correctional Health Professionals when establishing these  
            minimum standards.

          2)Mandates that inmates and wards of state and local  
            correctional and detention facilities who are known or  
            suspected to be pregnant be restrained in the least  
            restrictive way possible, consistent with the legitimate  
            security needs of each inmate or ward, when transported to and  
            from their respective facilities.  

          3)States legislative intent that adult and juvenile state and  
            local correctional and detention facilities develop policies  
            to ensure that pregnant inmates are restrained in the least  
            restrictive way, consistent with the legitimate security needs  
            of each inmate or ward, for purposes of transportation to and  
            from a correctional or detention facility.

           EXISTING LAW  :








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          1)Provides that pregnant inmates temporarily taken to the  
            hospital outside the prison for purposes of child-birth shall  
            be transported in the least restrictive way possible,  
            consistent with the legitimate security needs of each inmate.   
            Upon arrival at the hospital, once the inmate has been  
            declared by the attending physician to be in active labor, the  
            inmate shall not be shackled by the wrists, ankles, or both,  
            unless deemed necessary for the safety and security of the  
            inmate, the staff, and the public.  (Penal Code Section  
            5007.7.)

          2)Requires CSA to establish minimum standards for state and  
            local correctional facilities.  CSA shall review those  
            standards biennially and make any appropriate revisions.  The  
            standards shall include, but not be limited to, the following:  
            health and sanitary conditions, fire and life safety,  
            security, rehabilitation programs, recreation, treatment of  
            persons confined in state and local correctional facilities,  
            and personnel training.  [Penal Code Section 6030(a) and (b).]

          3)Provides that the standards require inmates who are received  
            by the facility while they are pregnant are provided all of  
            the following [Penal Code Section 6030(e)]:

             a)   A balanced, nutritious diet approved by a doctor;

             b)   Prenatal and postpartum information and health care,  
               including, but not limited to, access to necessary vitamins  
               as recommended by a doctor;

             c)   Information pertaining to childbirth education and  
               infant care; and,

             d)   A dental cleaning while in a state facility.

          4)States that the standards shall provide that at no time shall  
            a woman who is in labor be shackled by the wrists, ankles, or  
            both including during transport to a hospital, during  
            delivery, and while in recovery after giving birth, except as  
            provided in Penal Code Section 5007.7.  [Penal Code Section  
            6030(f).]

          5)Requires CSA to seek the advice of the California State  
            Sheriffs' Association, the Chief Probation Officers'  








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            Association of California, and other interested persons, when  
            establishing minimum standards for female inmates and pregnant  
            inmates in local adult and juvenile facilities.  [Penal Code  
            Section 6030(g)(5).]

          6)Provides that any female prisoner shall have the right to  
            summon and receive the services of any physician and surgeon  
            of her choice in order to determine whether she is pregnant.   
            If the prisoner is found to be pregnant, she is entitled to a  
            determination of the extent of the medical services needed by  
            her and to the receipt of these services from the physician  
            and surgeon of her choice.  Any expenses occasioned by the  
            services of a physician and surgeon whose services are not  
            provided by the institution shall be borne by the prisoner.   
            (Penal Code Section 3406.)

          7)States that any woman inmate who would give birth to a child  
            during her term of imprisonment may be temporarily taken to a  
            hospital outside the prison for the purposes of childbirth,  
            and the charge for hospital and medical care shall be charged  
            against the funds allocated to the institution.  (Penal Code  
            Section 3423.)

          8)Requires that any female in the custody of a local juvenile  
            facility, defined as any city, county, or regional facility  
            used for the confinement of juveniles for more than 24 hours,  
            shall have the right to summon and receive the services of any  
            physician and surgeon of her choice in order to determine  
            whether she is pregnant.  If she is found to be pregnant, she  
            is entitled to a determination of the extent of the medical  
            services needed by her and to the receipt of those services  
            from the physician and surgeon of her choice.  [Welfare and  
            Institutions Code Sections 222(a) and 1774(a).]

          9)Provides that a ward shall not be shackled by the wrists,  
            ankles, or both during labor, including during transport to a  
            hospital, during delivery, and while in recovery after giving  
            birth, subject to the security needs described in this  
            section.  Pregnant wards temporarily taken to a hospital  
            outside the facility for the purposes of childbirth shall be  
            transported in the least restrictive way possible, consistent  
            with the legitimate security needs of each ward.  Upon arrival  
            at the hospital, once the ward has been declared by the  
            attending physician to be in active labor, the ward shall not  
            be shackled by the wrists, ankles, or both, unless deemed  








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            necessary for the safety and security of the ward, the staff,  
            and the public.  [Welfare and Institutions Code Sections  
            222(b) and 1774(d).]

           FISCAL EFFECT  :   Unknown

           COMMENTS  :

           1)Author's Statement  :  According to the author, "In 2005,  
            California was the second state to require pregnant women who  
            are temporarily being taken to a hospital for childbirth to be  
            transported in the least restrictive way possible.  Since  
            then, other states have implemented safer measures to stop  
            shackling pregnant women altogether.  Unfortunately, in  
            California not all correctional facilities have implemented  
            policies that require officers to use least restrictive  
            restraints.  Currently, nearly two-thirds of county jails  
            shackle pregnant women in ways that could cause miscarriage or  
            other injuries.  Studies indicate that the incidence of minor  
            trauma, especially falls, increases as pregnancy progresses  
            and excessive shackling poses undue health risks to a woman  
            throughout her pregnancy. 

          "California has the third largest population of incarcerated  
            women in the country.  Tens of thousands of women go through  
            county jails every year and an average of 4% to 7% are  
            pregnant at some point in their custody.  Therefore, the use  
            of restraints and shackles when prisoners are transported  
            should be re-evaluated since the passage of AB 478 (Lieber,  
            2005). 

          "Assembly Bill 1900 would require CSA to create standards for  
            state and local correctional facilities by January 1, 2012 to  
            ensure that pregnant women are restrained in the least  
            restrictive way when being transported.  This will protect  
            financially strapped counties from being sued and ensure the  
            health and safety of pregnant incarcerated women.  The bill  
            also establishes findings that excessive shackling  
            significantly limits a pregnant woman's mobility (e.g.,  
            shackling by the ankles, across the belly, behind the woman's  
            back, and to another person) and can cause serious harm to the  
            woman and her pregnancy.  To avoid threatening the health of  
            pregnant women and potential legal challenge, it is critical  
            that policies are adopted ensuring that restraints are  
            properly used with this vulnerable population."








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           2)Background  :  AB 478 (Lieber), Chapter 608, Statutes of 2005,  
            prohibited the shackling of pregnant prisoners in labor,  
            during childbirth and during recovery from childbirth.  AB 478  
            also mandated CSA establish standards for state prisons by  
            January 1, 2007.  In addition, AB 478 required CSA to  
            establish these standards for county jails, but did not set a  
            time deadline.

          The CSA wrote the minimum standards to apply to the state  
            prisons.  However, instead of also writing the standards to  
            apply to county jails, the CSA instead directed each jail  
            facility in each county to incorporate these minimum standards  
            into their own facilities' policies and procedures manuals.   
            No time deadline was given for the counties to accomplish this  
            directive.

          According to the Legal Services for Prisoners with Children  
            (LSPC) report, "Stop Shackling: A report on the written  
            policies of California's counties on the use of restraints on  
            pregnant prisoners in labor" (March 2010), "[LSPC] reviewed  
            all of the written policies and other communications [it]  
            received from the various counties and found:

             a)   "33 counties have a written policy addressing shackling  
               of pregnant women in labor, childbirth or recovery;

             b)   "13 counties have no written policy addressing these  
               issues; and,

             c)   "12 counties did not respond at all.

            "[LSPC] studied the written policies of the 33 counties which  
            (sic) have them to determine whether or not they were in  
            compliance with Penal Code section 6030(f).  In [LSPC's] view,  
            'compliance' means that all of the elements of that statute  
            are present in the written regulation.  In contrast, a  
            county's written policy is 'not in total compliance' if one or  
            more elements of the statute are missing or are stated  
            inaccurately.  [LSPC] determined that:

             a)   "17 counties' written policies are in compliance; and,

             b)   "16 counties' written policies are not in total  
               compliance.








                                                                  AB 1900
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            "Thus, on the basis of [the] survey, [LSPC] can verify that  
            only 17 of 58 counties (less than a third) are in compliance  
            with [Penal Code] section 6030(f) four years after it went  
            into effect.  These include San Bernardino, Alameda and Fresno  
            counties.  The 29 non-complying counties either have no  
            written policy on shackling of pregnant women in labor (13  
            counties, including Los Angeles County) or their written  
            policies do not comply with all of the specific terms of  
            section 6030(f) (16 counties, including San Diego, Riverside  
            and Santa Clara counties)."

           3)Eighth Amendment Considerations  :   In 2007, Arkansas  
            Department of Correction (ADC) inmate Shawanna Nelson brought  
            a lawsuit against the Director of the ADC and an ADC  
            corrections officer.  [Nelson v. Corr. Med. Servs., (8th Cir.  
            2009) 583 F.3d 522.]  Nelson alleged that while giving birth  
            to her child she was forced to go through the final stages of  
            labor with both legs shackled to her hospital bed in violation  
            of the Eighth Amendment.  (Id. at p. 525.)  Nelson further  
            alleged that the ACD Director failed to ensure that  
            appropriate policies for the treatment of pregnant inmates  
            were implemented and that the officer assigned to accompany  
            her during labor, despite having witnessed her severe  
            contractions and despite the expressed wish of medical  
            personnel, failed to follow prison regulations requiring her  
            to balance any security concern against the medical needs of  
            the patient.  (Ibid.)  "Nelson argued that a reasonable  
            corrections officer would have known that she should not have  
            been restrained by shackles while on the verge of giving birth  
            and that she was in no condition to flee while her whole body  
            was engaged in moving her baby to birth."  (Ibid.)

          "The Eighth Amendment prohibits the infliction of cruel and  
            unusual punishments on those convicted of crimes."  [Nelson v.  
            Corr. Med. Servs., (8th Cir. 2009) 583 F.3d 522, 528 citing,  
            Wilson v. Seiter, (1991) 501 U.S. 294, 296-97 (111 S. Ct.  
            2321).]  A finding of an Eight Amendment violation requires  
            evidence that the offending conduct is wanton.  (Ibid.)  In  
            the context of the Eighth Amendment, the meaning of the word  
            "wanton" depends upon the circumstances in which the alleged  
            violation occurs.  For example, in cases involving prison  
            riots, "wantonness" is demonstrated by acting maliciously for  
            the purpose of causing harm.  [Nelson v. Corr. Med. Servs.,  
            (8th Cir. 2009) 583 F.3d 522, 528 citing, Whitley v. Albers,  








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            (1986) 475 U.S. 312, 320-21 (106 S. Ct. 1078).]  "The Eighth  
            Amendment standard for conditions of confinement and medical  
            care is different, and the constitutional question in such  
            cases is whether the defendant acted with deliberate  
            indifference."  [Nelson v. Corr. Med. Servs., (8th Cir. 2009)  
            583 F.3d 522, 528.]

          "A prison official is deliberately indifferent if she knows of  
            and disregards a serious medical need or a substantial risk to  
            an inmate's health or safety.  A claim of deliberate  
            indifference has both an objective and a subjective  
            component."  [Nelson v. Corr. Med. Servs., (8th Cir. 2009) 583  
            F.3d 522, 528-529.]

          In 2002, the United States Supreme Court provided guidance to  
            officials on the constitutional limits on restraining  
            prisoners.  [Hope v. Pelzer, (2002) 536 U.S. 730 (122 S. Ct.  
            2508).]  In Hope, an inmate brought a lawsuit alleging that  
            his Eighth Amendment rights had been violated by officials  
            responsible for handcuffing him to a prison hitching post.   
            (Id. at pp. 733-35.)  The Court determined that the prison  
            officials had acted with deliberate indifference to the  
            inmate's health and safety in violation of the Eighth  
            Amendment by restraining him despite the clear lack of "an  
            emergency situation," in a manner that "created a risk of  
            particular discomfort and humiliation."  (Id. at pp. 737-38.)

          A constitutional right is clearly established if it is  
            "sufficiently clear that a reasonable official would  
            understand that what he is doing violates that right."   
            [Nelson v. Corr. Med. Servs., (8th Cir. 2009) 583 F.3d 522,  
            531 citing, Hope v. Pelzer, (2002) 536 U.S. 730, 739 (122 S.  
            Ct. 2508).]  The Supreme Court "has made it clear that there  
            need not be a case with 'materially' or 'fundamentally'  
            similar facts in order for a reasonable person to know that  
            his or her conduct would violate the constitution."  [Young v.  
            Selk, (8th Cir. 2007) 508 F.3d 868, 875 quoting, Hope v.  
            Pelzer, (2002) 536 U.S. 730, 739 (122 S. Ct. 2508).]  Instead,  
            the unlawfulness must merely be apparent in light of  
            preexisting law.  [Hope v. Pelzer, (2002) 536 U.S. 730, 739  
            (122 S. Ct. 2508).]  Officials "can still be on notice that  
            their conduct violates established law even in novel factual  
            circumstances."  (Id. at p. 741.)

          Whether or not a prison officer should know that his or her  








                                                                  AB 1900
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            conduct presents a substantial risk to an inmate is a question  
            of fact subject to demonstration in the usual ways, including  
            inference from circumstantial evidence and a fact finder may  
            conclude that a prison official knew of a substantial risk  
            from the very fact that the risk was obvious.  [Nelson v.  
            Corr. Med. Servs., (8th Cir. 2009) 583 F.3d 522, 529.]

          In 1976, the Supreme Court decided Estelle v. Gamble, a leading  
            case in the development of Eighth Amendment law.  [Estelle v.  
            Gamble, (1976) 429 U.S. 97 (97 S. Ct. 285).]  Estelle was an  
            action brought against prison officials for providing an  
            inmate inadequate medical care.  (Id. at p. 98.)  The Court  
            concluded that either interference with care or infliction of  
            "unnecessary suffering" establishes deliberate indifference in  
            medical care cases in violation of the Eighth Amendment.  (Id.  
            at p. 103-05.)

          Moreover, at least one court has held that shackling a woman in  
            labor is inhumane and violates her constitutional rights.   
            [Women Prisoners of D.C. Dep't of Corr. v. District of  
            Columbia, (D.D.C. 1994) 877 F. Supp. 634, 668-69, modified in  
            part on other grounds, (D.D.C. 1995) 899 F. Supp. 659.]

          In conclusion, the Nelson court held that an inmate's  
            protections from being shackled during labor had been clearly  
            established by decisions of the Supreme Court and the lower  
            federal courts before the date of the incident in question  
            and, thus, the prison guard who accompanied Nelson into the  
            delivery room and shackled her to the bed had likely acted  
            with indifference, in violation of Nelson's Eighth Amendment  
            rights.  [Nelson v. Corr. Med. Servs., (8th Cir. 2009) 583  
            F.3d 522, 534.]

           4)Argument in Support  :  According to the  American Congress of  
            Obstetricians and Gynecologists  (the sponsor of this bill),  
            "Many people associate pregnancy with a low-risk condition.   
            However, pregnancy is not a benign condition.  Even for an  
            average risk woman who is not incarcerated, significant risks  
            exist.  Blood volume increases by 40%, and any situation which  
            causes her to bleed could quickly cause serious injury or  
            death to both the mother and/or the fetus.  During transport  
            to the hospital, the patient may need aggressive treatment  
            that can be encumbered by unnecessary restraints.

          "Overly restrictive transport in vehicles with limited  








                                                                  AB 1900
                                                                  Page 9

            ventilation, (sic) no access to water or restroom facilities  
            will put the pregnant prisoner at higher risk for a  
            life-threatening blood clot.  Falls, the risk of which is  
            increased with some types of restraints, could cause the  
            placenta to separate from the uterus, which creates an  
            imminent threat of death for the mother and fetus.  Lowering  
            the risk of falls is an important consideration in minimizing  
            the use of certain restraints, particularly restraints that  
            cause the pregnant prisoner to be chained to another  
            prisoner."  

           5)Argument in Opposition  :  According to the  Chief Probation  
            Officers of California  , "AB 1900 is a duplicative measure,  
            considering that the CSA already has regulations on how  
            pregnant inmates are to be restrained while being transported.  
             We share the concern of the author and others that female  
            wards are restrained in the most appropriate manner consistent  
            with the legitimate security needs; however, policies are  
            already in place to address this concern.  It is unnecessary  
            at this time to incur additional costs or (sic) rewriting and  
            training on standards that have already been put in place."

           6)Prior Legislation  :  AB 478 (Lieber) Chapter 608, Statutes of  
            2005, makes it illegal to deny inmates prenatal and postpartum  
            care, including access to vitamins and a basic dental  
            cleaning, and bans the shackling of women during labor,  
            delivery, and recovery.

           REGISTERED SUPPORT / OPPOSITION :   

           Support 
           
          American Congress of Obstetricians and Gynecologists (Sponsor)
          American Civil Liberties Union (Co-Sponsor)
          All of Us or None (Co-Sponsor)
          Center for Young Women's Development (Co-Sponsor)
          Legal Services for Prisoners with Children (Co-Sponsor)
          ACCESS/Women's Health Rights Coalition
          ASK Mentoring Outreach, Inc.
          California Attorneys for Criminal Justice
          California Catholic Conference
          California Church IMPACT
          California Commission on the Status of Women
          California Medical Association
          California Nurses Association








                                                                  AB 1900
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          California Public Defenders Association 
          California Women's Law Center
          California Women Lawyers 
          Centerforce
          Community Works West
          Crossroads Inc.
          Drug Policy Alliance
          Families to Amend California's Three Strikes
          Friends Committee on Legislation of CA
          Girls and Gangs
          Great Beginnings
          Law Students for Reproductive Justice 
          Life Support Alliance
          National Advocates for Pregnant Women
          National Council of Jewish Women
          Peace Over Violence
          Physicians for Reproductive Choice and Health
          Rainbow Services, Ltd.
          Taxpayers for Improving Public Safety
          Three Hands Together
          University of Southern CA-Post Conviction Justice Project
          Women's Community Clinic
          55 Individuals 

           Opposition 
           
          Chief Probation Officers of California
           

          Analysis Prepared by  :    Meghan Masera / PUB. S. / (916)  
          319-3744