BILL NUMBER: SB 1079	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Rubio

                        FEBRUARY 14, 2012

   An act to add Article 6 (commencing with Section 2695) to Chapter
4 of Title 1 of Part 3 of the Penal Code, relating to inmates.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1079, as introduced, Rubio. Inmates: medical treatment.
   Existing law vests responsibility in the Secretary of the
Department of Corrections and Rehabilitation for the supervision,
management, and control of the state prisons, and the responsibility
for the care, custody, treatment, training, discipline, and
employment of persons confined therein, and authorizes him or her to
prescribe and amend rules and regulations for the administration of
the prisons. Pursuant to this authority, existing regulations require
the department to provide medical services for inmates based on
medical necessity but not for certain treatments, surgeries, and
services, as specified.
   This bill would codify those regulations and provide that it is
declaratory of existing law.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Article 6 (commencing with Section 2695) is added to
Chapter 4 of Title 1 of Part 3 of the Penal Code, to read:

      Article 6.  Medical Care


   2695.  (a) The department shall only provide medical services for
inmates that are based on medical necessity and supported by outcome
data as effective medical care. In the absence of available outcome
data for a specific case, treatment will be based on the judgment of
the physician that the treatment is considered effective for the
purpose intended and is supported by diagnostic information and
consultations with appropriate specialists. Treatments for conditions
that might otherwise be excluded may be allowed pursuant to
subdivision (e) of Section 2696.
   (b) For the purposes of this article, the following definitions
apply:
   (1) "Medically necessary" means health care services that are
determined by the attending physician to be reasonable and necessary
to protect life, prevent significant illness or disability, or
alleviate severe pain, and are supported by health outcome data as
being effective medical care.
   (2) "Outcome data" means statistics like diagnoses, procedures,
discharge status, length of hospital stay, morbidity, and mortality
of patients, that are collected and evaluated using science-based
methodologies and expert clinical judgment for purposes of outcome
studies.
   (3) "Outcome study" means the definition, collection, and analysis
of comparable data, based on variations in treatment, concerning
patient health assessment for purposes of improving outcomes and
identifying cost-effective alternatives.
   (4) "Severe pain" means a degree of discomfort that significantly
disables the patient from reasonable independent function.
   (5) "Significant illness and disability" means a medical condition
that causes or may cause, if left untreated, a severe limitation of
function or ability to perform the daily activities of life or that
may cause premature death.
   2696.  (a) For purposes of this section, "treatment" refers to
attempted curative treatment and does not preclude palliative
therapies to alleviate serious debilitating conditions such as pain
management and nutritional support.
   (b) Treatment shall not be provided pursuant to this article for
the following conditions:
   (1) Conditions that improve on their own without treatment,
including, but not limited to, the following:
   (A) Common cold.
   (B) Mononucleosis.
   (C) Viral hepatitis A.
   (D) Viral pharyngitis.
   (E) Mild sprains.
   (2) Conditions that are not readily amenable to treatment,
including, but not limited to, those that may be made worse by
treatment with conventional medication or surgery, and those that are
so advanced in the disease process that the outcome would not change
with existing conventional or heroic treatment regimens. Examples
include, but are not limited to, the following:
   (A) Multiple organ transplants.
   (B) Temporomandibular joint dysfunction.
   (C) Grossly metastatic cancer.
   (3) Conditions that are cosmetic, including, but not limited to,
the following:
   (A) Removal of tattoos.
   (B) Removal of nontoxic goiter.
   (C) Breast reduction or enlargement.
   (D) Penile implants.
   (c) Surgery not medically necessary shall not be provided pursuant
to this article, including, but not limited to, the following:
   (1) Castration.
   (2) Vaginoplasty, except for Cystocele or Rectocele.
   (3) Vasectomy.
   (4) Tubal ligation.
   (d) Services that have no established outcome on morbidity or
improved mortality for acute health conditions shall not be provided
pursuant to this article, including, but not limited to:
   (1) Acupuncture.
   (2) Orthoptics.
   (3) Pleoptics.
   (e) Treatment for those conditions that are excluded within this
article may be provided in cases where both of the following criteria
are met:
   (1) The inmate's attending physician or dentist prescribes the
treatment.
   (2) The service is approved by the medical authorization review
committee, or the dental authorization review committee, and the
health care review committee. The decision of the applicable review
committee to approve an otherwise excluded service shall be based on
both of the following:
   (A) Available health and dental care outcome data supporting the
effectiveness of the services as medical or dental treatment.
   (B) Other factors, including, but not limited to, the following:
   (i) Coexisting medical or dental problems.
   (ii) Acuity.
   (iii) Length of the inmate's sentence.
   (iv) Availability of the service.
   (v) Cost.
  SEC. 2.  The addition of Article 6 (commencing with Section 2695)
to Chapter 4 of Title 1 of Part 3 of the Penal Code made by this act
does not constitute a change in, but is declaratory of, existing law.