BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
AB 999 (Bonta) - Prisoner Protections for Family and Community
Health Act.
Amended: May 24, 2013 Policy Vote: Public Safety 5-2
Urgency: No Mandate: No
Hearing Date: August 12, 2013
Consultant: Jolie Onodera
This bill meets the criteria for referral to the Suspense File.
Bill Summary: AB 999 would require the Department of Corrections
and Rehabilitation (CDCR) to develop a five-year plan to expand
the availability of condoms in California prisons, as specified.
Fiscal Impact:
Based on reported data from the pilot project, first year
costs for a statewide program would cost approximately
$200,000 based on a cost per inmate of $1.50 in the first
year, including the initial cost of the dispensers,
decreasing to $100,000 statewide, based on a cost of $0.76
per inmate for subsequent years.
Potential future annual costs to the CDCR in the range of
$100,000 (General Fund) to the extent sufficient donations
are no longer received after initial implementation of the
program. While implementation of the program is contingent
upon sufficient donations to CDCR, ongoing operation of the
program is not similarly subject to this requirement.
Annual CDCR costs of less than $25,000 (General Fund) to
administer and monitor the program.
Potential out-year significant savings in medical-related
costs to the CDCR and community at large to the extent the
availability of condoms results in fewer cases of HIV/AIDS.
It is estimated that very few HIV infections (less than four
cases) would need to be prevented for a cost-neutral
program.
Background: Existing law declares that the spread of HIV/AIDS
within prison and jail populations presents a grave danger to
inmates within those populations, law enforcement personnel, and
other persons in contact with a prisoner infected with the AIDS
virus, both during and after the prisoner's confinement (PC �
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7500). According to recent data from the California Correctional
Health Care Services (CCHCS), there are 1,055 inmates infected
and currently receiving treatment for HIV/AIDS in California's
prisons. Based on the average annual cost of care of $29,500
(including medication and laboratory tests, but exclusive of
clinical staff and additional diagnostic studies), the annual
costs to treat these inmates is estimated at over $31 million.
State regulations prohibit all sex acts, illegal and consensual,
between inmates (Title 15, California Code of Regulations �
3007). Existing law provides that any person who participates in
an act of sodomy with any person of any age while confined in
any state prison or local detention facility shall be punished
by imprisonment in state prison or county jail for up to one
year (PC � 286(e)). In addition, any person participating in an
act of oral copulation while confined in any state prison or
local detention facility shall be punished by imprisonment in
the state prison or county jail for up to one year (PC �
288a(e)).
AB 1334 (Swanson) of the 2007-08 would have required the CDCR to
allow nonprofit and health care agencies to enter prisons to
provide sexual barrier protection devices, including condoms.
The Governor's veto message noted that although it is unlawful
to engage in sexual activity while incarcerated, condom
distribution in prison is "not an unreasonable public policy and
is consistent with the need to improve our prison health care
system and overall public health."
Additionally, the Governor's veto message directed the CDCR to
determine the risk and viability of such a program by
identifying one state prison facility for the purpose of a pilot
program. As a result, a pilot program was implemented in Solano
State Prison, Facility II, for one year from November 5, 2008,
through November 4, 2009. Several agencies covered all costs for
the program and volunteered staff time and expertise. The Center
for Health Justice, a nonprofit organization, purchased the
condom dispensing machines and condoms, monitored and refilled
the dispensers throughout the pilot period, and provided
education for staff and inmates.
Various researchers from the Division of Correctional Health
Care Services and the State Department of Public Health provided
evaluation services and finalized their conclusions in a
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September 2011 report entitled, "Evaluation of a Prisoner Condom
Access Pilot Program Conducted in One California State Prison
Facility." The report concluded that there was no evidence that
providing condoms posed an increased risk to safety or security,
or resulted in injury to staff or inmates in a general
population prison facility setting. The report concluded that
providing condoms from dispensing machines is feasible and of
relatively low cost to implement and maintain. Finally, the
report concluded that providing condoms would likely reduce the
transmission of HIV, sexually transmitted diseases, and
hepatitis in CDCR prisons, thereby reducing medical costs in
both CDCR and the community.
Proposed Law: This bill would enact the "Prisoner Protections
for Family and Community Health Act," requiring the CDCR to
develop a five-year plan to expand the availability of condoms
in California prisons based on the recommendations contained in
the report, "Evaluation of a Prisoner Condom Access Pilot
Program Conducted in One California State Prison Facility," an
evaluation of the pilot project in California State Prison,
Solano. Specifically, this bill:
Makes specified findings regarding the use of condoms in
prison to prevent the spread of HIV/AIDS.
Requires that, beginning January 1, 2015, no less than
five prisons, as determined by the CDCR, be incorporated
into the program each year, with the final year yielding a
comprehensive plan that includes every prison in the state.
Requires CDCR, in developing the plan, to consider
specified recommendations made in the report:
o Initiate and incrementally expand a program to
provide inmate with access to condoms while continuing
to monitor the safety and acceptability of the
program.
o Consider additional pilot studies in settings
that may pose a serious health or safety risk, for
example, higher security facilities or housing for
inmates with serious mental health problems.
o Mount dispensers in discreet locations to
provide confidential access and increase accessibility
by minimizing inoperability due to vandalism.
o Consider making condoms available
confidentially upon request during a medical or mental
health visit, in addition to dispensing machines.
o Provide information to staff and inmates
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describing the findings from the current study
demonstrating that safety and security were not
impacted by the distribution of condoms.
o Include inmate peer educators, inmates', men's
and women's advisory councils, and medical public
health, and custody staff in local institutional
condom program planning and implementation.
Provides that all non-administrative costs of the
program, including the dispensers and condoms, be paid for
through donations and the implementation of the program is
contingent upon the receipt of sufficient donations to the
CDCR.
Prior Legislation: AB 1334 (Swanson) 2008 would have authorized
any nonprofit or health care agency to distribute sexual barrier
protection devices to inmates in state prisons. This bill was
vetoed by the Governor with the following message:
This bill would enact the Inmate and Community Public Health and
Safety Act, which would allow any nonprofit or health care
agency to distribute sexual barrier protection devices to
inmates in state prisons.
As stated in my veto of AB 1677 last year, the provisions of
this bill conflict with Penal Code Sections 286 (e) and 288 (e),
which make sexual activity in prison unlawful. However, condom
distribution in prisons is not an unreasonable public policy and
it is consistent with the need to improve our prison healthcare
system and overall public health.
Local jail systems in both Los Angeles and San Francisco have
already implemented condom distribution programs. Therefore, I
am directing the California Department of Corrections and
Rehabilitation to determine the risk and viability of such a
program by identifying one state prison facility for the purpose
of allowing non-profit and health agencies to distribute sexual
barrier devices.
AB 1677 (Koretz) 2006 was virtually identical to AB 1334. This
measure was vetoed by the Governor who stated the provisions of
the bill were in conflict with the Penal Code.
Staff Comments: Based on reported data from the pilot project,
first year costs for a statewide program would cost
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approximately $200,000 based on a cost per inmate of $1.50 in
the first year (based on the inmate population of approximately
133,000 as of July 2013), including the initial cost of the
dispensers, decreasing to $100,000 statewide, based on a cost of
$0.76 per inmate for subsequent years. While implementation of
the program is contingent upon sufficient donations for the
non-administrative costs of the program, including the
dispensers and condoms, it is not clear that the ongoing costs
of the program are subject to the same requirement. As a result,
to the extent sufficient donations are not received each year,
the costs of the program would be borne by the CDCR.
To the extent the availability of condoms results in fewer cases
of HIV/AIDS within state prisons, the potential for out-year
savings in medical-related costs to the CDCR and the community
at large is significant. Based on the CCHCS annual cost of
inmate care for HIV of $29,500, it is estimated that very few
HIV infections (less than 4 cases) would need to be prevented
for a cost-neutral program.
Recommended Amendments: In order to clarify that implementation
of the program is contingent upon donations from outside of the
department, staff recommends the following amendment on page 5,
line 31:
(d) The implementation of this program is contingent upon the
receipt of sufficient donations by to the department. All
nonadministrative costs of the program, including the dispensers
and condoms, shall be paid for through donations.
As noted in the report on the pilot project, the positive
results of the pilot may not necessarily be extrapolated to
every prison statewide considering the different missions and
classification levels at individual facilities. In order to
address this issue, staff recommends the following amendment:
6500. (a) Based on the recommendations contained in the
"Evaluation of a Prisoner Condom Access Pilot Program Conducted
in One California State Prison Facility" report, and in light of
the successful pilot project conducted at California State
Prison, Solano, the Department of Corrections and Rehabilitation
shall develop a five-year plan to expand the availability of
condoms in all California prisons where the department deems it
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is practicable to do so .
(b) Commencing January 1, 2015, no less than five prisons, as
determined by the department, shall be incorporated into the
program each year, with the final year yielding a comprehensive
plan that includes every all prison s in the state where the
department deems it is practicable to do so .