BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 1135|
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THIRD READING
Bill No: SB 1135
Author: Jackson (D), Anderson (R), Hancock (D), Lowenthal (D)
Amended: 3/24/14
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 4/2/14
AYES: Hernandez, Anderson, Beall, De Le�n, DeSaulnier, Evans,
Monning, Nielsen, Wolk
SENATE PUBLIC SAFETY COMMITTEE : 6-0, 4/29/14
AYES: Hancock, Anderson, Knight, Liu, Mitchell, Steinberg
NO VOTE RECORDED: De Le�n
SENATE APPROPRIATIONS COMMITTEE : 7-0, 5/23/14
AYES: De Le�n, Walters, Gaines, Hill, Lara, Padilla, Steinberg
SUBJECT : Inmates: sterilization
SOURCE : Justice Now
DIGEST : This bill prohibits sterilization for the purpose of
birth control, including, but not limited to, during labor and
delivery, of an individual under the control of the Department
of Corrections and Rehabilitation (CDCR) or a county and
imprisoned in the state prison or a reentry facility, community
correctional facility, county jail, or any other institution in
which an individual is involuntarily confined or detained under
a civil or criminal statute.
ANALYSIS : Existing statutory law:
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1.Prohibits the use in prisons of any cruel, corporal or unusual
punishment or to inflict any treatment or allow any lack of
care that would injure or impair the health of the prisoner,
inmate or person confined.
2.Prohibits an order for a particular medical treatment by a
physician employed by the CDCR from being modified or canceled
by any employee of CDCR without the approval of the chief
medical officer of the institution or the physician in
attendance, except to protect the safety and security of the
institution, as specified.
Existing regulations:
1.Limit the provision of medical services for inmates of CDCR to
only those services that are medically necessary.
2.Define "medically necessary," for purposes of medical care
provided to incarcerated persons, as 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.
3.Define "significant illness or disability," for purposes of
medical care provided to incarcerated persons, as any 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.
4.Exclude certain medical treatment for incarcerated persons,
including surgery that is not medically necessary, which
specifically includes, but is not limited to, vasectomy and
tubal ligation.
5.Permit treatment of excluded conditions in cases where the
incarcerated person's attending physician prescribes the
treatment, and the service is approved by the medical
authorization review committee.
6.Require the decision of the medical authorization review
committee, when determining whether to allow treatment of an
excluded condition, to base the decision on:
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A. Available health and dental care outcome data supporting
the effectiveness of the services; and,
B. Other factors, including, but not limited to,
co-existing medical problems, acuity, length of the
incarcerated person's sentence, availability of the
service, and cost.
This bill:
1.Prohibits sterilization for the purpose of birth control,
including, but not limited to, during labor and delivery, of
an individual under the control of CDCR or a county and
imprisoned in the state prison or a reentry facility,
community correctional facility, county jail, or any other
institution in which an individual is involuntarily confined
or detained under a civil or criminal statute.
2.Prohibits sterilization of an individual under the control of
CDCR or a county and imprisoned in the state prison or a
reentry facility, community correctional facility, county
jail, or any other institution in which an individual is
involuntarily confined or detained under a civil or criminal
statute, through tubal ligation, hysterectomy, oophorectomy,
or any other means rendering an individual permanently
incapable of reproducing, except if:
A. The procedure is required for the immediate preservation
of the individual's life in an emergency medical situation;
or,
B. The procedure is required for the necessary treatment of
a physical medical condition, excluding birth control, and
only if all of the following requirements are satisfied:
1) Less drastic measures to address the medical need
are non-existent, are refused by the individual, or are
first attempted and deemed unsuccessful;
2) A second physician independent of, and not employed
by, but authorized to provide services to individuals in
the custody of, and to receive payment for those services
from, the department or county department overseeing the
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confinement of the individual conducts an in-person
consultation and confirms the need for a medical
intervention resulting in sterilization to address the
medical need; and,
3) Patient consent is obtained after the individual is
made aware of the full and permanent impact the procedure
will have on his or her reproductive capacity, that
future medical treatment while under the control of the
department or county will not be withheld should the
individual refuse consent to the procedure, and the side
effects of the procedure.
1.Requires, if a sterilization procedure is performed pursuant
to a) or b) above, pre-sterilization and post-sterilization
psychological consultation and medical follow up, including
providing relevant hormone therapy to address surgical
menopause, to be made available to the individual sterilized
while under the control of CDCR or the county.
2.Requires CDCR and all county jails or other institutions of
confinement to publish an annual report of sterilizations
performed, disaggregated by race, age, medical justification,
and method of sterilization, including, but not limited to,
hysterectomy and oophorectomy.
3.Requires CDCR to provide notification to all individuals under
their custody and to all employees who are involved in
providing health care services of their rights and
responsibilities under these provisions.
4.Entitles an employee of CDCR or of a county jail or other
institution of confinement who reports the sterilization of an
individual performed in violation of these provisions to the
protection available under existing law related to retaliation
and whistleblower protections.
Background
On July 7, 2013, the Sacramento Bee reported that female
inmates, in the custody of CDCR, were sterilized without
approval.
Doctors under contract with CDCR sterilized nearly 150
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female inmates from 2006 to 2010 without required state
approvals, the Center for Investigative Reporting has
found.
At least 148 women received tubal ligations in violation of
prison rules during those five years - and there are
perhaps 100 more dating back to the late 1990s, according
to state documents and interviews.
From 1997 to 2010, the state paid doctors $147,460 to
perform the procedure, according to a database of
contracted medical services for state prisoners.
The women were signed up for the surgery while they were
pregnant and housed at either the California Institution
for Women in Corona or Valley State Prison for Women in
Chowchilla, which is now a men's prison.
Former inmates and prisoner advocates maintain that prison
medical staff coerced the women, targeting those deemed
likely to return to prison in the future.
(Female Inmates Sterilized without Approval, Corey G. Johnson,
Sacramento Bee, July 7, 2013,
http://www.sacbee.com/2013/07/07/5549696/female-inmates-sterilize
d-in-california.html.)
In response to this report, on August 13, 2013, the Senate
Public Safety Committee held an informational hearing regarding
female sterilization in California prisons. The hearing
included representatives from CDCR, experts from Justice Now,
and the Federal Receiver.
Prior Legislation
SB 1079 (Rubio, 2012) would have codified existing regulations
limiting medical services for CDCR inmates to only those
services which are medically necessary, excluding treatment for
sexual dysfunction or infertility, gender reassignment surgery,
and weight reduction surgery. The bill failed passage in the
Senate Public Safety Committee.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
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According to the Senate Appropriations Committee:
Minor ongoing costs (General Fund) to CDCR to provide
psychological consultations, as CDCR has indicated the
provisions of this bill are consistent with current policy.
Potentially significant state-reimbursable costs (General
Fund) incurred by local agencies statewide for mandated
medical professional activities including second opinion
in-person consultations, psychological counseling, and medical
follow up to the extent sterilization of an individual is
considered or performed under limited circumstances in county
facilities.
Minor to significant state-reimbursable costs (General Fund)
to local agencies to provide notification to all applicable
employees and persons in custody of the rights and
responsibilities specified in this measure, as well as prepare
and publish an annual report on sterilizations performed.
Costs would be dependent on the volume and method in which
notification is provided, which is not currently specified.
SUPPORT : (Verified 5/23/14)
Justice Now (source)
All of Us or None
American Civil Liberties Union
Berkeley Law Center on Reproductive Rights and Justice
Black and Pink, San Diego
California Correctional Health Care Services
California Partnership to End Domestic Violence
California Catholic Conference, Inc.
Californians United for a Responsible Budget
Department of Obstetrics University of California, San Francisco
Critical Resistance
Friends Committee on Legislation of California
Legal Services for Women Prisoners with Children
National Asian Pacific Islander Women's Forum
Planned Parenthood Affiliates of California
Sister Song
Women's Foundation
Women Fight Back
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Women With a Vision
OPPOSITION : (Verified 5/23/14)
American Congress of Obstetricians and Gynecologists, District
IX California
Taxpayers for Improving Public Safety
ARGUMENTS IN SUPPORT : Justice Now states that sterilization
of an individual for birth control purposes in the prison
environment mimics the long-since discredited coercive
sterilization patterns of women of color and women living in
poverty, e.g. the sterilization of hundreds of Mexican-American
women at USC-Los Angeles, mass sterilization of women in Puerto
Rico, Black women in the U.S. South, and Native women during the
20th century. According to Justice Now, the time for California
to actively address its shameful eugenic legacy is long overdue.
All Of Us Or None and Legal Services for Prisoners with
Children write that these medical practices are unethical, and
advising unnecessary surgeries using misinformation, asking for
women's consent during labor, childbirth, or during a C-section,
and pushing women to have surgeries they expressly opposed is a
complete breach of the legal right to informed consent. Planned
Parenthood Affiliates of California states that while all women
should be able to make autonomous decisions about their
reproductive future, the coercive nature of the prison system
raises the question of whether true consent can ever be
achieved. The ACLU of California writes that California, a
state with enlightened reproductive health policies, has simply
failed to establish procedures that allow women to obtain
reproductive health care while protecting their rights in the
coercive prison environment and this bill takes an important
step to prevent further sterilization abuse.
ARGUMENTS IN OPPOSITION : The American Congress of
Obstetricians and Gynecologists, District IX (California) (ACOG)
writes that women in almost all circumstances enter the penal
system already pregnant and it is possible that some of these
women would have signed consent for sterilization prior to being
incarcerated. Under this bill, this consent would be
invalidated, although the reasons for banning sterilization for
the purposes of birth control should not be applicable in this
instance. ACOG states that given the inherently coercive
environment of incarceration, an adequate process for permitting
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procedures such as tubal ligation may be difficult if not
impossible to design, but they would like the opportunity to
try.
Taxpayers for Improving Public Safety believes this legislation
creates the assumption that a specific class of individuals,
i.e., prison inmates, lack the intelligence to make decisions
about their rights as it relates to "reproductive choice" simply
because they are in custody.
JL:nl 5/25/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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