BILL ANALYSIS                                                                                                                                                                                                    �







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

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          SB 913 (Pavley)                                             
          As Amended March 29, 2011 
          Hearing date:  April 5, 2011
          Welfare and Institutions Code
          AA:mc

                                   JUVENILE JUSTICE:

                                    MEDICAL CARE  


                                       HISTORY

          Source:  Los Angeles County Board of Supervisors

          Prior Legislation: None

          Support: Unknown

          Opposition:None known

           


                                        KEY ISSUES
           
          SHOULD PROBATION OFFICERS HAVE THE STATUTORY AUTHORITY TO ORDER A 
          MEDICAL EXAM FOR AN ARRESTED MINOR, AS SPECIFIED?

          SHOULD PROBATION OFFICERS HAVE THE STATUTORY AUTHORITY TO ORDER 
          MEDICAL, SURGICAL, DENTAL OR OTHER REMEDIAL CARE RECOMMENDED BY AN 
          ATTENDING HEALTH CARE PROFESSIONAL FOR AN ARRESTED MINOR WHERE THE 
          OFFICER HAS MADE REASONABLE EFFORTS TO NOTIFY AND OBTAIN THE CONSENT 




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          OF A PARENT OR GUARDIAN, AND THE PARENT OR GUARDIAN DOES NOT OBJECT, 
          AS SPECIFIED?
           


                                       PURPOSE

          The purpose of this bill is to provide probation officers with 
          the statutory authority to 1) order a medical exam for an 
          arrested minor, as specified; and 2) order medical, surgical, 
          dental or other remedial care recommended by an attending health 
          care professional for an arrested minor where the officer has 
          made reasonable efforts to notify and obtain the consent of a 
          parent or guardian, and the parent or guardian does not object, 
          as specified.

           Current law  generally authorizes a peace officer to take a minor 
          into temporary custody without a warrant where the officer has 
          reasonable cause to believe the minor is delinquent, a ward of 

























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          the court, or in need of medical care, as specified.<1>  
          (Welfare and Institutions Code ("WIC") � 625.)

           Current law  generally provides statutory authority for how 
          minors who have been taken into temporary custody can receive 
          medical, surgical, dental or other remedial care.  (WIC � 739.)  


           Current law  specifically provides that the "probation officer 
          shall notify the parent, guardian, or person standing in loco 
          parentis of the person, if any, of the care found to be needed 
          before the care is provided, and if the parent, guardian, or 
          person standing in loco parentis objects, the care shall be 
          given only upon order of the court in the exercise of its 
          discretion."  If there is no parent or other person capable or 
          willing to authorize treatment, current law authorizes the court 
          ---------------------------
          <1>   Specifically, WIC section 625 provides that a "peace 
          officer may, without a warrant, take  into temporary custody a 
          minor:  (a) Who is under the age of 18 years when such officer 
          has reasonable cause for believing that such minor is a person 
          described in Section 601 or 602, or (b) Who is a ward of the 
          juvenile court or concerning whom an order has been made under 
          Section 636 or 702, when such officer has reasonable cause for 
          believing that person has violated an order of the juvenile 
          court or has escaped from any commitment ordered by the juvenile 
          court, or (c) Who is under the age of 18 years and who is found 
          in any street or public place suffering from any sickness or 
          injury which requires care, medical treatment, hospitalization, 
          or other remedial care.  In any case where a minor is taken into 
          temporary custody on the ground that there is reasonable cause 
          for believing that such minor is a person described in Section 
          601 or 602, or that he has violated an order of the juvenile 
          court or escaped from any commitment ordered by the juvenile 
          court, the officer shall advise such minor that anything he says 
          can be used against him and shall advise him of his 
          constitutional rights, including his right to remain silent, his 
          right to have counsel present during any interrogation, and his 
          right to have counsel appointed if he is unable to afford 
          counsel.  




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          to make an order for the performance of the necessary care, as 
          specified.  (Id.)  

           This bill  would provide statutory authority for the probation 
          officer to authorize a medical exam that complies with the 
          regulations promulgated by the Corrections Standards Authority.

           This bill  would authorize probation officers to authorize any 
          follow-up treatment recommended by the physician as a result of 
          the medical exam, if the minor remains in the temporary custody 
          of the probation officer.

           This bill  further would provide that if the person is in need of 
          medical care, as specified, the probation officer would be 
          authorized to order the care if the officer makes "reasonable 
          efforts to notify and obtain the consent" of a parent or 
          guardian, as specified.  The bill retains existing law which 
          provides that if the parent or guardian, as specified, objects, 
          the care shall be given only upon order of the court.

           This bill  would provide that nothing in the section this bill is 
          amending "shall be construed to interfere with a minor's right 
          to make medical decisions pursuant to existing law."


                    RECEIVERSHIP/OVERCROWDING CRISIS AGGRAVATION
          
          For the last several years, severe overcrowding in California's 
          prisons has been the focus of evolving and expensive litigation. 
           As these cases have progressed, prison conditions have 
          continued to be assailed, and the scrutiny of the federal courts 
          over California's prisons has intensified.  

          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 




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

          On Monday, June 14, 2010, the U.S. Supreme Court agreed to hear 
          the state's appeal of this order and, on Tuesday, November 30, 
          2010, the Court heard oral arguments.  A decision is expected as 
          early as this spring.  

          In response to the unresolved prison capacity crisis, in early 
          2007 the Senate Committee on Public Safety began holding 
          legislative proposals which could further exacerbate prison 
          overcrowding through new or expanded felony prosecutions.     

           This bill  does not appear to aggravate the prison overcrowding 
          crisis described above.
           

                                      COMMENTS

          1.  Stated Need for This Bill

           The author states:

               State regulations require a routine physical 
               examination of all minors within 96-hours of being 
               taken into custody and detained in juvenile halls.  
               The routine physical examination includes, but is not 
               limited to, blood tests and other lab work, 
               immunizations, administration of medication, x-rays, 
               all of which requires the consent of a parent or legal 
               guardian.  In most cases, the parent or legal guardian 
               cannot be found or does not respond to requests for 
               consent, which could leave the minor, as well as other 
               juvenile detainees, at risk for undetected medical 
               conditions.  It is critical that statutory authority 




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               be given to County Probation Officers to provide 
               consent for routine medical examinations if the parent 
               or legal guardian cannot be found or does not respond 
               to requests for consent.  A minor's health could be 
               jeopardized without receiving prompt medical attention 
               once detained, as well as the health of the other 
               detainees and the staff of the Probation Department. 





































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               State law mandates that consent from a parent or legal 
               guardian be obtained in order to perform or administer 
               blood tests and other lab work, immunizations, 
               medications, and x-rays on a minor.  There are many 
               cases when a minor's medical care is delayed because 
               medical consent cannot be obtained from a parent or 
               legal guardian.  Delay in treatment may ultimately 
               land the child in the emergency room, thus aggravating 
               overcrowded ERs and exacerbating costs. 

          2.  What This Bill Would Do
           
          This bill would amend existing statutory language regarding 
          medical care for minors who have been taken into temporary 
          custody.  Specifically, this bill would provide clear statutory 
          authority for probation officers to order a medical exam for a 
          minor who has been taken into temporary custody.  As noted by 
          the author, current regulations applicable to local juvenile 
          facilities require that minors who are detained in local 
          juvenile facilities, like juvenile halls, require a health 
          appraisal/medical examination within 96 hours of admission.  
          (CCR Title 15, � 1432.)  This bill would clarify the statutory 
          authority to conduct these initial assessment exams.  This bill 
          also would provide that a probation officer may also authorize 
          any followup treatment recommended by the physician as a result 
          of the medical exam, if the minor remains in the temporary 
          custody of the probation officer.

          Existing regulations similarly address consent for health care.  
          (CCR Title 15 � 1434 et seq.)  This bill would allow probation 
          officers to authorize medical, surgical, dental or other 
          remedial care recommended by an attending health care 
          professional for an arrested minor where the officer has made 
          reasonable efforts to notify and obtain the consent of a parent 
          or guardian, and the parent or guardian does not object.

          3.  Suggested Technical Amendments

           The author and/or the Committee may wish to consider whether the 




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          language in the bill as now drafted might be revised to make its 
          provisions more clear.  The following suggestions are reflected 
          in strikeout and underlining; the amendments now in the bill are 
          reflected in italics:

               . . .  If the person  is in need of medical, surgical, 
               dental, or other remedial care  and the   , provided  the  
               probation officer  has made a reasonable but 
               unsuccessful effort to notify the parent, guardian, or 
               person standing in loco parentis of the person,   first 
               makes a reasonable effort,  the probation officer may, 
               upon the recommendation of the attending physician and 
               surgeon or, if the person needs dental care and there 
               is an attending dentist, the attending dentist, 
               authorize the performance of that medical, surgical, 
               dental, or other remedial care.  The probation officer 
               may also authorize any followup treatment recommended 
               by the physician as a result of the medical exam, if 
               the minor remains in the temporary custody of the 
               probation officer.    The probation officer also may 
               authorize any additional treatment necessary for the 
               health of the minor and recommended by the physician 
               as a result of the medical exam, provided that the 
               minor remains in the temporary custody of the 
               probation officer.   The probation officer shall make 
               reasonable efforts to notify and obtain the consent of 
               the parent, guardian, or person standing in loco 
               parentis of the person, if any, of the care found to 
               be needed before the care is provided, and if the 
               parent, guardian, or person standing in loco parentis 
               objects, the care shall be given only upon order of 
               the court in the exercise of its discretion.


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