BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2530
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          Date of Hearing:   April 17, 2012
          Consultant:      Jesse Stout


                         ASSEMBLY COMMITTEE ON PUBLIC SAFETY
                                 Tom Ammiano, Chair

                    AB 2530 (Atkins) - As Amended:  March 29, 2012
           

          SUMMARY  :  Prohibits the shackling of inmates and wards 
          incarcerated by the Department of Corrections and Rehabilitation 
          (CDCR) who are known to be pregnant or in recovery after 
          delivery, with leg irons, waist chains, or handcuffs behind the 
          body. Specifically,  this bill  : 

          1)Prohibits the restraint of an inmate known to be pregnant or 
            in recovery after delivery by use of leg irons, waist chains, 
            or handcuffs behind the body.

          2)Prohibits the restraint of an inmate who is pregnant, in 
            labor, delivering, or recovering after delivery, by the 
            wrists, ankles, or both, unless deemed necessary for the 
            safety and security of the inmate, the staff, or the public.

          3)Requires that restraints be removed when a professional who is 
            responsible for the pregnant inmate's medical care during a 
            medical emergency, labor, delivery, or recovery after delivery 
            determines the removal of restraints is medically necessary.

          4)Provides that this bill shall not be interpreted to require 
            restraints in a case where restraints are not required 
            pursuant to a statute, regulation, or correctional facility 
            policy.

          5)Requires that upon confirmation of an inmate's pregnancy, she 
            shall be advised, orally or in writing, of the standards and 
            policies governing pregnant inmates, including, but not 
            limited to, the provisions of this chapter, the relevant 
            regulations, and the correctional facility policies.

          6)Requires that the Board of State and Community Corrections 
            (BSCC), in the minimum standards for local correctional 
            facilities, include a requirement that pregnant inmates be 
            notified, orally or in writing, of specified rights. 








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          7)Requires that the BSCC minimum standards for local 
            correctional facilities provide that a woman known to be 
            pregnant or in recovery after delivery shall not be 
            restrained, except as provided in this bill.

          8)Requires that the BSCC develop standards regarding the 
            restraint of pregnant women at the next biennial review of the 
            standards after this bill's passage, and review the individual 
            facilities' compliance with the standards.

           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 Sections 
            222(b) and 1774(d).]

          3)Requires BSCC 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 








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            facilities, and personnel training.  �Penal Code Section 
            6030(a) and (b).]

          4)Provides that BSCC'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 BSCC'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 Welfare and Institutions Code Section 
            222(b).]

          6)Requires BSCC 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 or local juvenile facility 
            ward 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.  
            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 and Welfare 
            and Institutions Code Sections 222(a) and 1774(a).]

          8)States that a woman inmate who would give birth to a child 








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            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; the 
            inmate 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, unless 
            deemed necessary for the safety and security of the inmate, 
            the staff, and the public.  (Penal Code Section 3423.)

          9)Provides that mechanical restraints shall not be placed on an 
            adult inmate during labor, including during transport to a 
            hospital, during delivery, and while in recovery after giving 
            birth, unless circumstances exist that require the immediate 
            application of mechanical restraints to avoid the imminent 
            threat of death, escape, or great bodily injury, and only for 
            the period during which such threat exists.  (15 Cal. Code of 
            Regs. Section 3268.2.)

           FISCAL EFFECT  :   Unknown

           COMMENTS  : 

           1)Author's Statement  :  According to the author, "California has 
            the third largest population of incarcerated women in the 
            country.  Tens of thousands of women go through state prison 
            and county jails every year and 4-7% are pregnant.  While the 
            passage of AB 478 (Lieber) in 2005 intended to limit harmful 
            restraints on pregnant inmates during labor, surveys taken 
            four years later showed that most facilities had not 
            implemented policies to comply with state law.

            "Pregnant women are frequently shackled by the ankles, wrists, 
            belly, behind the back, and even to other people while being 
            transported to and from correctional facilities causing many 
            to fall.  Studies indicate that the incidence of minor trauma, 
            especially from falls, increases as pregnancy progresses and 
            excessive shackling poses undue health risks to a woman 
            throughout her pregnancy.

            "Pregnant women in correctional facilities are more likely to 
            experience miscarriage, preeclampsia, preterm birth, and low 
            birth-weight infants.  The added stress of maneuvering with 
            excessive restraints could lead to further complications while 
            rendering doctors unable to treat them properly. 








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            "Federal courts recently established that prison officials are 
            in violation of pregnant incarcerated women's rights and may 
            be civilly liable when they act with deliberate indifference 
            to their health and safety.  Most pregnant women receive 
            sentences of less than one year in duration, often for 
            first-time nonviolent, nonserious offenses.  Nevertheless, 
            women as far along as eight months pregnant have been shackled 
            in the most restrictive ways posing threats to their health 
            and safety.  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. 

            "AB 2530 would prohibit the use of the most restrictive and 
            dangerous kinds of shackling for pregnant women while 
            clarifying that during labor, delivery or recovery certain 
            restraints shall not be used unless deemed necessary for a 
            safety and security purpose.  It would ensure that doctors are 
            able to treat pregnant women in emergency situations and 
            affirms the role of the Board of Corrections in reviewing 
            local policies for consistency with state law.  This will 
            protect counties and the state from being sued and ensure the 
            health and safety of incarcerated women and their pregnancies. 


            "Similar bills have twice passed the Legislature without any 
            'no' votes, most recently with AB 568.  AB 2530 directly 
            addresses issues raised in the AB 568 veto message by 
            clarifying language and responsibilities." 

           2)Background  :  According to information provided by the author, 
            "Existing law prohibits shackling by the wrists and ankles 
            only during labor, delivery, and recovery, which leaves women 
            in various stages of pregnancy vulnerable to potentially 
            injurious falls throughout their pregnancy.  Current law also 
            has a provision that is sometimes unworkable in practice; it 
            requires a doctor to determine whether a woman is in labor 
            which may negate the requirement that women in labor not be 
            shackled during transport to the hospital for the purposes of 
            labor. 

            "This bill would prohibit the most dangerous forms of 
            restraint (leg irons, waist chains, and handcuffs behind the 
            back) from being used on any incarcerated woman known to be 








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            pregnant.  The bill clarifies that women in labor are not 
            restrained by the wrists, ankles, or both during labor, 
            delivery, and recovery after delivery, including during 
            transport, unless deemed necessary for the safety and security 
            of the inmate, staff, or the public.  It also allows for 
            medical professionals' requests for the removal of restraints 
            be granted in emergency situations."

              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. 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 








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               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 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 








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               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 Effect on this 
               Bill  :  AB 568, introduced last year, was similar to this 
               bill.  In his veto message, the Governor stated:
                
             "At first blush, I was inclined to sign this bill because it 
            certainly seems inappropriate to shackle a pregnant inmate 
            unless absolutely necessary. However, the language of this 
            measure goes too far, prohibiting not only shackling, but also 
            the use of handcuffs or restraints of any kind except under 
            ill-defined circumstances.

            "Let's be clear. Inmates, whether pregnant or not, need to be 
            transported in a manner that is safe for them and others. The 








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            restrictive criteria set forth in this bill go beyond what is 
            necessary to protect the health and dignity of pregnant 
            inmates and will only serve to sow confusion and invite 
            lawsuits."
             
             This bill addresses these concerns by clarifying the relevant 
            language and responsibilities.  Instead of prohibiting the 
            practice of shackling as in AB 568, AB 2530 prohibits specific 
            shackles: leg irons, waist chains, and handcuffs behind the 
            body.  Instead of allowing the least restrictive means of 
            restraint when "deemed necessary", AB 2530 more specifically 
            allows restraints unless deemed necessary for the safety and 
            security of the inmate, staff, or public.  This bill 
            additionally clarifies that restraints shall be removed when a 
            medical professional determines the removal is medically 
            necessary.

              5)   Legislation is Necessary to Protect Pregnant Inmates 
               Being Transported to Hospitals  :  Even though the California 
               Code of Regulations currently requires counties to 
               incorporate the BSCC's minimum standards into jails' 
               policies and procedure manuals, Legal Services for 
               Prisoners with Children (LSPC) found in "Stop Shackling: A 
               Report on the Written Policies California's Counties on the 
               Use of Restraints on Pregnant Prisoners in Labor" that many 
               counties have not done so.  �Penal Code Section 6030(f).]  
               According to "Stop Shackling," 17 counties have adopted 
               these minimum standards, 13 counties including Los Angeles 
               have no written policy on shackling of pregnant women in 
               labor, and 16 counties' written policies do not comply with 
               the specific terms of Section 6030(f).  �"Stop Shackling," 
               LSPC (March 2010).]  This bill would solve this problem of 
               inconsistency by providing a clear statewide rule.  

             6)   Argument in Support  :  According to the  American Congress 
               of Obstetricians and Gynecologists, District IX 
               (California)  , "Restraints pose serious risks to the 
               pregnant woman when medical complications occur and 
               physical access required for treatment by medical personnel 
               is severely restricted.  Many of our physicians have 
               reported harrowing stories of attempting to treat pregnant 
               women who were not in labor but had other life-threatening 
               medical conditions.  The restraints rendered it virtually 
               impossible to provide the urgently needed care."









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              7)   Argument in Opposition  :  According to the  California 
               State Sheriffs' Association  , "This bill is directed towards 
               policies and procedures in place by the California 
               Department of Corrections and Rehabilitation (CDCR), yet 
               requires the Board of State and Community Corrections 
               (BSCC) under Title 15 for local facilities to adopt 
               standards regarding restraint of pregnant inmates in 
               prison.  The BSCC does not set standards for the CDCR, nor 
               does it set transportation standards for local adult 
                    facilities (county jails)."

           8)Related Legislation  :  

             a)   AB 568 (Skinner) would have required that pregnant 
               inmates and wards not be shackled by the wrists, ankles, 
               around the abdomen, or to another person, unless deemed 
               necessary for safety, and if necessary, be restrained in 
               the least restrictive way possible.  AB 568 was vetoed.  

             b)   AB 30 (Hayashi) would have inserted a subsection 
               pertaining to the Correctional Standards Authority'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 was held in the Assembly 
               Appropriations Committee.  
                
            9)Prior Legislation  :
             
             a)   AB 1900 (Skinner), of the 2009-10 Legislative Session, 
               would have prohibited the use of restraints on pregnant 
               inmates while they are being transported.  AB 1900 was 
               vetoed.

             b)   AB 478 (Lieber), Chapter 608, Statutes of 2005, 
               prohibited denying 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 
           
          ACCESS Women's Health Justice








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          American Association of University Women - California
          American Civil Liberties Union of California
          American Congress of Obstetricians and Gynecologists, District 
          IX (California)
          Asian Communities for Reproductive Justice
          California Attorneys for Criminal Justice
          California Catholic Conference, Inc.
          California Family Health Council
          California Medical Association
          California National Organization for Women
          California Public Defenders Association
          Californians United for a Responsible Budget
          Center for Young Women's Development
          Critical Resistance
          Law Students for Reproductive Justice
          Legal Services for Prisoners with Children
          National Council of Jewish Women, California
          National Council of Jewish Women Los Angeles
          Physicians for Reproductive Choice and Health
          Rainbow Services, Ltd.
          Service Employees International Union, Local 1000

           Opposition 
           
          Chief Probation Officers of California
          California Probation, Parole and Correctional Association
          California State Sheriffs' Association
           
          Analysis Prepared by  :    Jesse Stout / PUB. S. / (916) 319-3744