BILL ANALYSIS                                                                                                                                                                                                    �







                      SENATE COMMITTEE ON PUBLIC SAFETY
                            Senator Loni Hancock, Chair              A
                             2011-2012 Regular Session               B

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          AB 2530 (Atkins)                                           0
          As Amended May 9, 2012
          Hearing date:  June 26, 2012
          Penal Code; Welfare and Institutions Code
          SM:mc

                              SHACKLING PREGNANT INMATES  

                                       HISTORY

          Source:  ACLU; American Congress of Obstetricians and 
          Gynecologists, District IX; 
                   Legal Services for Prisoners with Children

          Prior Legislation: AB 568 (Skinner) - 2011, vetoed 
                       AB 1900 (Skinner) - 2010, vetoed
                       AB 478 (Lieber) - Chap. 608, Stats. of  2005

          Support: ACCESS Women's Health Justice; ACT for Women and Girls; 
                   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 
                   Nurses Association; California Public Defenders 
                   Association; Californians United for a Responsible 
                   Budget; Center for Elders' Independence; Center for 
                   Restorative Justice Works; Center for Young Women's 
                   Development; Critical Resistance; Directors of Public 
                   Health Nursing; Harriett Buhai Center for Family Law; 
                   Law Students for Reproductive Justice; National 
                   Association of Social Workers, California Chapter; 
                   National Center for Lesbian Rights; National Council of 




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                   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; Women's Community 
                   Clinic; American Medical Women's Association; Drug 
                   Policy Alliance; California Latinas for Reproductive 
                   Justice; American Association of University Women - 
                   California; Latino Health Alliance

          Opposition:None known

          Assembly Floor Vote:  Ayes  75 - Noes  0


                                        KEY ISSUES
           
          SHOULD CURRENT PROVISIONS OF THE PENAL CODE AND WELFARE AND 
          INSTITUTIONS CODE RELATING TO SHACKLING OF PREGNANT STATE INMATES 
          AND JUVENILE WARDS BE DELETED AND REPLACED WITH SPECIFIED NEW 
          STANDARDS ON SHACKLING THESE PRISONERS?

          SHOULD THE BOARD OF STATE AND COMMUNITY CORRECTIONS BE REQUIRED TO 
          ADD ITS PROPOSED NEW STANDARDS FOR SHACKLING PREGNANT INMATES AND 
          WARDS TO THE MINIMUM STANDARDS IT IS CURRENTLY REQUIRED TO ESTABLISH 
          FOR LOCAL CORRECTIONAL FACILITIES?



                                       PURPOSE

          The purpose of this bill is to (1) delete current provisions of 
          the Penal Code and Welfare and Institutions Code relating to 
          shackling of pregnant state inmates and juvenile wards and 
          replace them with specified new standards on shackling these 
          prisoners; (2) require the Board of State and Community 
          Corrections (BSCC) to add its proposed new standards for 
          shackling pregnant inmates and wards to the minimum standards it 
          is currently required to establish for local correctional 
          facilities; (3) require BSCC to also add to its minimum 
          standards that inmates received by the facility while they are 




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          pregnant be given oral or written notification of specified 
          existing health requirements.

           Current law  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 � 5007.7.)

           Current law  requires the Board of State and Community 
          Corrections (BSCC, formerly the Corrections Standards Authority) 
          to establish minimum standards for state and local correctional 
          facilities.  BSCC 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 � 6030(a) and (b).)

           Current law  provides that the standards require inmates who are 
          received by the facility while they are pregnant are provided 
          all of the following (Penal Code � 6030(e)):

                 A balanced, nutritious diet approved by a doctor;
                 Prenatal and postpartum information and health care, 
               including, but not limited to, access to necessary vitamins 
               as recommended by a doctor;
                 Information pertaining to childbirth education and 
               infant care; and,
                 A dental cleaning while in a state facility.

           Current law  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 




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          provided in Penal Code Section 5007.7.  (Penal Code � 6030(f).)

           Current law  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 inmates and pregnant 
          inmates in local adult and juvenile facilities.  (Penal Code � 
          6030(g)(5).)

           Current law  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
          � 3406.)

           Current law  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 � 
          3423.)

           Current law  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 �� 222(a) and 1774(a).)

           Current law  provides that a ward shall not be shackled by the 




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          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 necessary for the 
          safety and security of the ward, the staff, and the public.  
          (Welfare and Institutions Code �� 222(b) and 1774(d).)
           
          Current law  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. � 3268.2.)

           This bill  would delete current provisions of the Penal Code and 
          Welfare and Institutions Code relating to shackling of pregnant 
          state inmates and juvenile wards (detailed above) and replace 
          them with the following new provisions:

                 An inmate known to be pregnant or in recovery after 
               delivery shall not be restrained by the use of leg irons, 
               waist chains, or handcuffs behind the body.
                 A pregnant inmate in labor, during delivery, or in 
               recovery after delivery, shall not be restrained by the 
               wrists, ankles, or both, unless deemed necessary for the 
               safety and security of the inmate, the staff, or the 
               public.
                 Restraints shall be removed when a professional who is 
               currently responsible for the medical care of a pregnant 
               inmate during a medical emergency, labor, delivery, or 
               recovery after delivery determines that the removal of 
               restraints is medically necessary.




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                 This section shall not be interpreted to require 
               restraints in a case where restraints are not required 
               pursuant to a statute, regulation, or correctional facility 
               policy.
                 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.
                 For purposes of this section, "inmate" means an adult or 
               juvenile who is incarcerated in a state or local 
               correctional facility.

           This bill  would require the BSCC to add the following to the 
          minimum standards it is currently required to establish for 
          local correctional facilities:

                 That a woman known to be pregnant or in recovery after 
               delivery shall not be restrained, except as specified 
               above.  The board shall develop standards regarding the 
               restraint of pregnant women at the next biennial review of 
               the standards after the enactment of the act amending this 
               subdivision and shall review the individual facilities' 
               compliance with the standards.
                 That inmates received by the facility while they are 
               pregnant be given oral or written notification of existing 
               requirements that they receive:
             o    A balanced, nutritious diet approved by a doctor.
             o    Prenatal and postpartum information and health care, 
               including, but not limited to,          access to necessary 
               vitamins as recommended by a doctor.
             o    Information pertaining to childbirth education and 
               infant care.
             o    A dental cleaning while in a state facility.



                    RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION
                                      ("ROCA")
          




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          In response to the unresolved prison capacity crisis, since 
          early 2007 it has been the policy of the chair of the Senate 
          Committee on Public Safety and the Senate President pro Tem to 
          hold legislative proposals which could further aggravate prison 
          overcrowding through new or expanded felony prosecutions.  Under 
          the resulting policy known as "ROCA" (which stands for 
          "Receivership/Overcrowding Crisis Aggravation"), the Committee 
          has held measures which create a new felony, expand the scope or 
          penalty of an existing felony, or otherwise increase the 
          application of a felony in a manner which could exacerbate the 
          prison overcrowding crisis by expanding the availability or 
          length of prison terms (such as extending the statute of 
          limitations for felonies or constricting statutory parole 
          standards).  In addition, proposed expansions to the 
          classification of felonies enacted last year by AB 109 (the 2011 
          Public Safety Realignment) which may be punishable in jail and 
          not prison (Penal Code section 1170(h)) would be subject to ROCA 
          because an offender's criminal record could make the offender 
          ineligible for jail and therefore subject to state prison.  
          Under these principles, ROCA has been applied as a 
          content-neutral, provisional measure necessary to ensure that 
          the Legislature does not erode progress towards reducing prison 
          overcrowding by passing legislation which could increase the 
          prison population.  ROCA will continue until prison overcrowding 
          is resolved.

          For the last several years, severe overcrowding in California's 
          prisons has been the focus of evolving and expensive litigation. 
           On June 30, 2005, in a class action lawsuit filed four years 
          earlier, the United States District Court for the Northern 
          District of California established a Receivership to take 
          control of the delivery of medical services to all California 
          state prisoners confined by the California Department of 
          Corrections and Rehabilitation ("CDCR").  In December of 2006, 
          plaintiffs in two federal lawsuits against CDCR sought a 
          court-ordered limit on the prison population pursuant to the 
          federal Prison Litigation Reform Act.  On January 12, 2010, a 
          three-judge federal panel issued an order requiring California 
          to reduce its inmate population to 137.5 percent of design 
          capacity -- a reduction at that time of roughly 40,000 inmates 




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          -- within two years.  The court stayed implementation of its 
          ruling pending the state's appeal to the U.S. Supreme Court.  

          On May 23, 2011, the United States Supreme Court upheld the 
          decision of the three-judge panel in its entirety, giving 
          California two years from the date of its ruling to reduce its 
          prison population to 137.5 percent of design capacity, subject 
          to the right of the state to seek modifications in appropriate 
          circumstances.  Design capacity is the number of inmates a 
          prison can house based on one inmate per cell, single-level 
          bunks in dormitories, and no beds in places not designed for 
          housing.  Current design capacity in CDCR's 33 institutions is 
          79,650.

          On January 6, 2012, CDCR announced that California had cut 
          prison overcrowding by more than 11,000 inmates over the last 
          six months, a reduction largely accomplished by the passage of 
          Assembly Bill 109.  Under the prisoner-reduction order, the 
          inmate population in California's 33 prisons must be no more 
          than the following:

                 167 percent of design capacity by December 27, 2011 
               (133,016 inmates);
                 155 percent by June 27, 2012;
                 147 percent by December 27, 2012; and
                 137.5 percent by June 27, 2013.
               
           This bill  does not aggravate the prison overcrowding crisis 
          described above under ROCA.

                                      COMMENTS

          1.  Need for This Bill  

          According to 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 




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               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 pregnant consistent with the 
               Governor's veto message on the previous bill.  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 the removal of restraints in emergency 
               situations where requested by the professional 
               responsible for the woman's medical care.


          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 and mandated that the 
          Corrections 
          Standards Authority (CSA) (soon to be known as the Board of 
          State and Community Corrections) establish, by January 1, 2007, 
          minimum standards for state prisons incorporating that 
          prohibition.  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.  (15 Cal. Code of Regs. � 3268.2.)  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' 




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          policies and procedures manuals.  (15 Cal. Code of Regs. � 
          1029.<1>)  No deadline was established 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:

               Thus, on the basis of our survey, we can verify that 
               only 17 of 58 counties (less than a third) are in 
               compliance with 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).  For example, several 
               counties list section 5007.7's exceptions to section 
               6030's prohibition on shackling prisoners in labor, 
               without stating the prohibition itself, as explicitly 
               mandated by section 6030(f) �"The standards shall 
               ----------------------
          <1> Cal. Code of Regs. section 1029 states, in pertinent part:  
          "Policy and Procedures Manual.  Facility administrator(s) shall 
          develop and publish a manual of policy and procedures for the 
          facility.  The policy and procedures manual shall address all 
          applicable Title 15 and Title 24 regulations and shall be 
          comprehensively reviewed and updated at least every two years.  
          Such a manual shall be made available to all employees. (a) The 
          manual for Temporary Holding, Type I, II, and III facilities 
          shall provide for, but not be limited to, the following: 
          (4) Policy on the use of restraint equipment, including the 
          restraint of pregnant inmates as referenced in Penal Code 
          Section 6030(f)."





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               provide that at no time shall a woman who is in labor 
               be shackled . . ."].  Some counties fail to address 
               the issue of shackling a woman while she is in 
               recovery after giving birth.  (LSPC Report on file 
               with Committee.)

              3.   Constitutional Standards
           
          The Eighth Amendment to the United States Constitution provides 
          that "Excessive bail shall not be required, nor excessive fines 
          imposed, nor cruel and unusual punishments inflicted."  

































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          The Supreme Court has determined: 

               �D]eliberate indifference to serious medical needs of 
               prisoners constitutes the "unnecessary and wanton 
               infliction of pain," proscribed by the Eighth 
               Amendment.  This is true whether the indifference is 
               manifested by prison doctors in their response to the 
                      prisoner's needs or by prison guards in intentionally 
               denying or delaying access to medical care or 
               intentionally interfering with the treatment once 
               prescribed.  Regardless of how evidenced, deliberate 
               indifference to a prisoner's serious illness or injury 
               states a cause of action under � 1983. (Estelle v. 
               Gamble, 429 U.S. 97, 104-105 (1976), footnotes and 
               citations omitted.)

          In 2009, the Eighth Circuit Court of Appeals found that 
          shackling a pregnant inmate while she is in labor and during 
          childbirth constitutes an Eighth Amendment violation.  (Nelson 
          v. Corr. Med. Servs., 583 F.3d 522 (8th Cir. 2009).) Although 
          Nelson involved shackling a woman who was in labor and during 
          childbirth, the same principles could apply to any unnecessary 
          shackling of a pregnant inmate if that use of mechanical 
          restraint caused foreseeable harm to the mother or fetus.  "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."  (Id. at  528.)  To establish an 
          Eighth Amendment violation "it is enough that the official acted 
          or failed to act despite �her] knowledge of a substantial risk 
          of serious harm."  (Nelson, supra, at 529.)  

          4.  Governor's Veto Message of AB 568  

               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 




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               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 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.

          5.  Statement in Support

           The California Medical Association states:

               Using restraints that significantly limit a pregnant 
               inmate's mobility, such as leg shackles, chains across 
               the belly or shackling wrists behind the back can 
               cause serious and undue health risks to the woman and 
               her pregnancy.  The vast majority of female prisoners 
               or detainees incarcerated are non-violent offenders, 
               and shackling them greatly increases their chances for 
               physical harm if they trip or fall.  Pregnant women 
               have a different center of gravity.  If she trips and 
               falls while her ankles are shackled, chances are good 
               that she will not be able to restore her balance and 
               could suffer a terrible injury.

               The American Medical Association passed a resolution 
               at its 2010 House of Delegates strongly condemning 
               this practice, calling it "a barbaric and inhumane 
               practice that needlessly inflicts pain and 
               humiliation."  
           

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