BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 568
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          Date of Hearing:   April 12, 2011
          Consultant:           Stefani Salt


                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY
                                 Tom Ammiano, Chair

                 AB 568 (Skinner) - As Introduced:  February 16, 2011
           

                                        REVISED
           

          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 to be pregnant, shall not be 
          shackled by the wrists, ankles, around the abdomen, or to 
          another person, unless deemed necessary for safety, and if 
          necessary for safety, be restrained in the least restrictive way 
          possible.  Specifically,  this bill  :  

          1)Requires that an inmate or ward known to be pregnant shall not 
            be shackled by the wrists, ankles, around the abdomen, or to 
            another person, unless deemed necessary for the safety and 
            security of the inmate or ward, the staff, or the public.  
            Provides that in cases where restraints are deemed necessary, 
            the least restrictive means shall be used, consistent with the 
            legitimate security needs of each inmate.  States that these 
            provisions apply to, but are not limited to, movement within 
            the correctional facility, transport to and from the facility 
            and time spent outside the facility to receive medical or 
            dental care, to attend court or another appointment.

          2)Requires that, as part of its biennial review of minimum 
            standards, the Corrections Standards Authority (CSA) establish 
            new minimum standards regarding the shackling of pregnant 
            women.

          3)Makes the following declarations and findings:

              a)    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 
                four to seven percent are pregnant.








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              b)    The health and safety of pregnant inmates shall be a 
                primary concern of all adult and juvenile state and local 
                correctional and detention facilities.

              c)    Using restraints that significantly limit a pregnant 
                inmate's mobility can cause serious and undue health risks 
                to the woman and her pregnancy.

              d)    Potentially harmful methods of restraint include, but 
                are not limited to, shackling by the ankles, the wrists in 
                front or behind the body, across the abdomen, or to 
                another person.

              e)    To avoid threatening the health of pregnant women and 
                potential legal challenges, it is critical that policies 
                are adopted ensuring that restraints are properly used 
                with this vulnerable population.

              f)    It is critical that, adult and juvenile state and 
                local correctional and detention facilities develop 
                policies that ensure inmates who are known to be pregnant 
                are not restrained unless deemed necessary for the 
                security of the inmate, staff, the public, or all 
                combined. Should restraints be necessary under these 
                circumstances, facilities are instructed to use the least 
                restrictive means of restraint as determined by CSA.

              g)    These policies must meet the minimum standards 
                established by CSA for the proper use of restraints on 
                pregnant inmates during transport, as established pursuant 
                to Penal Code Section 6030.

              h)    Pursuant to Penal Code Section 6030, the CSA has the 
                authority to issue minimum standards for treatment of 
                people incarcerated within correctional facilities, 
                treatment of inmates in custody during temporary 
                appointments outside correctional facilities, and 
                transportation of inmates among correctional facilities 
                and to and from appointments outside of correctional 
                facilities.  The CSA has previously promulgated 
                transportation regulations, including, but not limited to, 
                requiring local correctional facilities to provide 
                transportation for inmates in need of medical services as 
                set forth in subdivision (c) of Section 1206 of Title 15 








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                of the California Code of Regulations, and requiring all 
                juvenile facilities to provide transportation for minors 
                to mental health facilities as set forth in subdivision 
                (f) of Section 1437 of Title 15 of the California Code of 
                Regulations, and that all juvenile facilities have 
                adequate transportation staff as set forth in subdivision 
                (g) of Section 1321 of Title 15 of the California Code of 
                Regulations. The CSA has also previously established 
                regulations addressing the treatment of inmates 
                temporarily taken outside of correctional facilities, 
                including requiring local correctional facilities to 
                create policies and procedures for handling situations 
                such as furloughs and other temporary releases, and 
                requiring facilities to have adequate field supervision 
                staff, as set forth in Sections 1027, 1029, and 1351 of 
                Title 15 of the California Code of Regulations.

           EXISTING LAW  :

          1)Declares that pregnant inmates temporarily taken to a hospital 
            outside the prison for purposes of childbirth shall be 
            transported in the least restrictive way possible, consistent 
            with the legitimate security needs of each inmate.  States 
            that, 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)States 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 security needs, as specified.  Provides that 
            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.  Requires that, 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 
            necessary for the safety and security of the ward, the staff 
            and the public.  �Welfare and Institutions Code (WIC) Sections 
            222(b) and 1774(d).]









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          3)Requires CSA to establish minimum standards for state and 
            local correctional facilities and to review those standards 
            biennially.  Provides that those standards will include, but 
            not be limited to: 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).]

          4)Provides that CSA's minimum standards must require inmates who 
            are received by the facility while they are pregnant to be 
            provided 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.

          5)Mandates CSA's minimum standards to provide that at no time 
            shall a woman in labor be shackled by the wrists, ankles, or 
            both including during transport to a hospital, during delivery 
            and while in recovery, except as specified.  �Penal Code 
            Section 6030(f) and WIC Section 222(b).]

          6)Requires CSA to seek the advice of the California State 
            Sheriffs' Association, the Chief Probation Officers' 
            Association of California, and other interested persons, when 
            establishing minimum standards for female and pregnant inmates 
            in local adult and juvenile facilities.  �Penal Code Section 
            6030(g)(5).]

          7)Mandates that a female prisoner has the right to summon and 
            receive the services of a 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 








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            provided by the institution shall be borne by the prisoner.  
            �Penal Code Section 3406 and WIC Sections 222(a) and 1774(a).]

          8)States that a 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 that the charge for hospital and medical care shall be 
            charged against the funds allocated to the institution.  
            (Penal Code Section 3423.)

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           1)Author's Statement  :  According to the author, "Pregnant women 
            in correctional facilities are more likely to experience 
            miscarriage, preeclampsia, preterm birth, and low-birth weight 
            infants.  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.  Despite the dangers of shackling, 
            correctional facilities have inconsistent policies and 
            practices for restraining pregnant incarcerated women. 

          "Pregnant women are frequently shackled by the ankles, wrists, 
            abdomen, behind the back, and even to another person while 
            being transported to and from a correctional facility.  Most 
            pregnant women receive sentences of less than 1 year in 
            duration, often for first-time nonviolent, non-serious 
            offenses.  Nevertheless, women as far along as 8 months 
            pregnant have been shackled in the most restrictive ways.  To 
            avoid threatening the health of pregnant women and potential 
            legal challenges, it is critical that policies are adopted 
            ensuring that restraints are properly used with this 
            vulnerable population.

          "�This bill] clarifies �CSA's] standards for how pregnant women 
            are restrained during transport to and from facilities.  �This 
            bill] will protect counties and the state from being sued and 
            ensure the health and safety of incarcerated women and their 
            pregnancy. 

          "Response to Veto:  Last year a similar bill AB 1900 was vetoed 
            because of the administration's interpretation of CSA's 
            authority to establish policies on transportation issues to 








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            and from other locations.  Governor Schwarzenegger's assertion 
            that the CSA has no authority at all over the transportation 
            of inmates appears to be incorrect.  While Penal Code Section 
            6030 does not expressly grant rulemaking power over inmate 
            transportation to the CSA, it does grant the CSA some degree 
            of authority over transportation by mandating that women in 
            labor shall not be shackled during transport.  �Penal Code 
            Section 6030(f).]

          "Furthermore, the regulations promulgated by the CSA in Title 15 
            of the California Code of Regulations indicate that it 
            currently regulates at least some aspects of inmate 
            transportation.  While CSA regulations are not as specific as 
            those established by the CDCR, the CSA requires that local 
            facilities must develop policies to comply with the restraint 
            requirements for women in labor laid out in Penal Code Section 
            6030(f).  15 C.C.R. � 1029(a)(4).  The CSA also requires that 
            local correctional facilities must provide transportation for 
            inmates in need of medical services.  15 C.C.R. � 1206(c). 

          "Additionally, the CSA further requires that all juvenile 
            facilities provide transportation for minors to mental health 
            facilities, and that all juvenile facilities have adequate 
            transportation staff.  15 C.C.R. �� 1321(g), 1437(f).  It thus 
            does not appear that a regulation regarding the transport of 
            pregnant inmates falls outside the scope of the CSA's 
            authority."

           2)Background  :  According to the information provided by 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.  In 2009, nearly two-thirds of county 
            jails did not have written policies limiting shackling in 
            compliance with AB 478.  This encourages restraint practices 
            that could cause miscarriage or other injuries for pregnant 
            women.  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. 









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          "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 4-7% 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). 

          "�This bill], would require that �CSA] clarify standards for 
            state, local, adult, and juvenile correctional facilities 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."

           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 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.  (Id.)  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."  (Id.)

          "The Eighth Amendment prohibits the infliction of cruel and 
            unusual punishments on those convicted of crimes."  �Nelson v. 








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            Corr. Med. Servs., supra, 583 F.3d 522, 528 citing, Wilson v. 
            Seiter (1991) 501 U.S. 294, 296-97.]  A finding of an Eight 
            Amendment violation requires evidence that the offending 
            conduct is wanton.  (Id.)  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., supra, 583 F.3d 522, 528 
            citing, Whitley v. Albers (1986) 475 U.S. 312, 320-21.]  "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., supra, 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., supra, 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.]  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 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 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., supra, 583 F.3d 522, 531 citing, 
            Hope v. Pelzer, supra, 536 U.S. 730, 739.]  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 








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            F.3d 868, 875 quoting, Hope v. Pelzer, supra, 536 U.S. 730, 
            739.]  Instead, the unlawfulness must merely be apparent in 
            light of preexisting law.  �Hope v. Pelzer, supra, 536 U.S. 
            730, 739.]  Officials "can still be on notice that their 
            conduct violates established law even in novel factual 
            circumstances."  (Id. at 741.)

          Whether or not a prison officer should know that his or her 
            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., supra, 583 F.3d 522, 
            529 citing, Farmer v. Brennan (1994) 511 U.S. 825, 842.]

          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.]  Estelle was an action brought 
            against prison officials for providing an inmate inadequate 
            medical care.  (Id. at 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 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, vacated 
            in part and remanded, (D.C. Cir. 1996) 93 F.3d 910.] 

          In conclusion, the Nelson court held that an inmate's protection 
            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., supra, 583 F.3d 522, 534.]  
           
           4)Veto of Previous Similar Legislation and the Effect on This 
            Bill  :  AB 1900, introduced in the last session, was similar in 
            its final form to this legislation.  The Governor stated:









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          "This bill would prohibit the shackling of pregnant inmates and 
            wards during transport to and from correctional facilities 
            except when other less restrictive restraints are deemed 
            necessary. Additionally, this bill would require the 
            Corrections Standards Authority (CSA) to develop guidelines 
            concerning the shackling of pregnant inmates and wards during 
            transport.  However, CSA's mission is to regulate and develop 
            standards for correctional facilities, not establish policies 
            on transportation issues to and from other locations.
 
          "Since this bill goes beyond the scope of CSA's mission, I am 
            unable to sign this bill."

          This bill includes a legislative finding that CSA has the 
            authority to issue minimum standards for transportation of 
            inmates among correctional facilities and to and from 
            appointments outside of correctional facilities.  This should 
            clarify that these responsibilities are within the purview of 
            CSA's mission and avoid further confusion.

           5)Related Legislation  :  AB 30 (Hayashi) inserts a subsection 
            pertaining to CSA's development of standards for a safety and 
            security plan to prevent and protect health care personnel who 
            provide care in state and local correctional facilities from 
            aggression and violence.    AB 30 passed in the Health 
            Committee and will be heard by the Assembly Appropriations 
            Committee.

           6)Previous Legislation  :  

             a)   AB 1900 (Skinner), of the 2009-10 Legislative Session, 
               was vetoed.  AB 1900 would have extended the current 
               prohibition established by AB 478 to also limit the use of 
               restraints on pregnant inmates while they are being 
               transported.

             b)   AB 478 (Lieber), Chapter 608, Statutes of 2005, made it 
               illegal to deny inmates prenatal and postpartum care, 
               including access to vitamins and a basic dental cleaning, 
               and banned the shackling of women during labor, delivery, 
               and recovery. 

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 








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          American College of Obstetricians and Gynecologists (Sponsor)
          American Civil Liberties Union (Co-Sponsor)
          California Commission on the Status of Women (Co-Sponsor)
          Center for Young Women's Development (Co-Sponsor)
          Legal Services for Prisoners with Children (Co-Sponsor) 
          Time for Change Foundation (Co-Sponsor)
          AAUW California
          ACT for Women and Girls
          A New Way of Life Reentry Project
          Books Not Bars
          California Attorneys for Criminal Justice
          California Catholic Conference
          California Coalition for Women Prisoners
          California Communities United Institute
          California Correctional Peace Officers Association
          California Medical Association
          California National Organization for Women
          California Nurses Association
          California Public Defenders Association
          Californians United for a Responsible Budget
          California Women's Law Center
          Center for Restorative Justice Works
          Community Works West
          Correctional Association of New York
          Drug Policy Alliance
          Equal Justice Society
          Families to Amend California's Three Strikes
          Friends Committee on Legislation of California
          Girls and Gangs
          Great Beginnings for Black Babies
          House of Ruth
          Just Detention International
          Justice Now
          Law Students for Reproductive Justice 
          Lawyers' Committee for Civil Rights of the San Francisco Bay 
          Area
          National Center for Youth Law
          National Council of Jewish Women Los Angeles Section
          Prison Activist Resource Center
          Prison Law Office
          Rainbow Services
          Rebecca Project for Human Rights
          San Francisco Board of Supervisors' Public Safety Committee
          San Francisco Juvenile Probation Department








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          Service Employees International Union
          Violence Prevention Coalition of Greater Los Angeles
          Women's Community Clinic
          Women's Foundation of California
          Youth and Family Services of Solano County
          Youth Law Center
          One private individual

           Opposition 
           
          None
           

          Analysis Prepared by  :    Stefani Salt / PUB. S. / (916) 319-3744