BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1135
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          SENATE THIRD READING
          SB 1135 (Jackson)
          As Amended  August 11, 2014
          Majority vote 

           SENATE VOTE  :36-0  
           
           PUBLIC SAFETY       7-0         HEALTH              19-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Ammiano, Melendez,        |Ayes:|Pan, Maienschein,         |
          |     |Jones-Sawyer, Quirk,      |     |Ammiano, Bonilla, Bonta,  |
          |     |Skinner, Stone, Waldron   |     |Ch�vez, Chesbro, Gomez,   |
          |     |                          |     |Gonzalez, Roger           |
          |     |                          |     |Hern�ndez, Lowenthal,     |
          |     |                          |     |Mansoor, Nazarian,        |
          |     |                          |     |Waldron, Patterson,       |
          |     |                          |     |Ridley-Thomas, Rodriguez, |
          |     |                          |     |Wagner, Wieckowski        |
           ----------------------------------------------------------------- 

          APPROPRIATIONS      17-0                                        
           
           -------------------------------- 
          |Ayes:|Gatto, Bigelow,           |
          |     |Bocanegra, Bradford, Ian  |
          |     |Calderon, Campos,         |
          |     |Donnelly, Eggman, Gomez,  |
          |     |Holden, Jones, Linder,    |
          |     |Pan, Quirk,               |
          |     |Ridley-Thomas, Wagner,    |
          |     |Weber                     |
          |     |                          |
           -------------------------------- 

           SUMMARY  :  Prohibits sterilization, with limited exceptions, of  
          an individual under the control of the California Department of  
          Corrections and Rehabilitation (CDCR) or a county correctional  
          facility, as specified.  Specifically,  this bill  :   

          1)Prohibits sterilization, for the purpose of birth control, of  
            any person who is involuntarily confined or detained under a  
            civil or criminal statute, including inmates in state prison,  
            reentry facilities, community correctional facilities and  








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            county jails.

          2)States that sterilization of an individual under the control  
            of CDCR or a county and imprisoned in a state prison, 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,  
            salpingectomy, or any other means rendering an individual  
            permanently incapable of reproducing, is prohibited except in  
            either of the following circumstances:

             a)   The procedure is required for the immediate preservation  
               of the individual's life in an emergency medical situation;  
               or,

             b)   The sterilization procedure is medically necessary, as  
               determined by contemporary standards of evidence-based  
               medicine, to treat a diagnosed condition, and all of the  
               following requirements are satisfied:

               i)     Less invasive measures to address the medical need  
                 are nonexistent, are refused by the individual, or are  
                 first attempted and deemed unsuccessful by the  
                 individual, in consultation with his or her medical  
                 provider;

               ii)    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, CDCR or county department overseeing the  
                 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,

               iii)   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 CDCR  
                 or county will not be withheld should the individual  
                 refuse consent to the procedure, and the side effects of  
                 the procedure.









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          3)Requires that any inmate who undergoes sterilization be  
            provided with a presterilization and poststerilization  
            psychological consultation and medical follow-up, including  
            providing relevant hormone therapy to address surgical  
            menopause, made available to the individual sterilized while  
            under the control of CDCR or the county.

          4)States that CDCR, if a sterilization is performed on one or  
            more individuals under its control, shall annually publish on  
            its Web site data related to the number of sterilizations  
            performed, disaggregated by race, age, medical justification,  
            and method of sterilization.

          5)Requires each county jail or other institution of confinement,  
            if a sterilization is performed on one or more individuals  
            under its control, to annually submit to the Board of State  
            and Community Corrections (BSCC) data related to the number of  
            sterilizations performed, disaggregated by race, age, medical  
            justification, and method of sterilization.

          6)Provides that BSCC shall annually publish the data received by  
            county jails and other institutions of confinement related to  
            sterilizations performed in those institutions.

          7)Requires CDCR and all county jails or other institutions of  
            confinement 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 the provisions of this bill.

          8)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.

           EXISTING LAW  :

          1)Excludes 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.

          2)Allows treatment for excluded conditions in cases where all of  








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            the following criteria are met:

             a)   The inmate's attending physician or dentist prescribed  
               the treatment as clinically necessary; and,

             b)   The service is approved by the appropriate Utilization  
               Management Committee.  The committee's decision shall be  
               based on: 

               i)     Available health and dental care outcome data  
                 supporting the effectiveness of the services as medical  
                 or dental treatment; and,

               ii)    Other factors, such as:  coexisting medical or  
                 dental problems; acuity; length of inmate's sentence;  
                 availability of the service; and, cost. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)Minor and absorbable state costs; CDCR indicates this bill  
            aligns with their current practice.

          2)Potential, likely minor, state-reimbursable mandate costs to  
            offer additional services and follow specified procedures  
            related to sterilization, to notify incarcerated individuals  
            and employees, and to publish reports. 

           COMMENTS  :  According to the author, "The Center for  
          Investigative Reporting, based on information gained through  
          working with Justice Now, broke a story in 2013 that documented  
          cases of coerced tubal ligations as late as 2010.

          "In addition to coerced tubal ligations, Justice Now also found  
          an alarming number of incarcerated women who have lost their  
          reproductive capacity through the overly aggressive use of  
          hysterectomies.  Too often, hysterectomies in prison appear to  
          be the first option for medical problems, such as fibroids, that  
          may have more effective and less drastic cures.  Many women have  
          had partial and full hysterectomies while incarcerated that were  
          later deemed unnecessary.

          "Women were robbed of their reproductive choice by these coerced  
          procedures.  Sterilizations that occurred under the watch of  








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          California's corrections department smack of eugenics.  These  
          acts are unconscionable.  It is well past time we put an end to  
          them and make sure situations like this never happen again."

          Please see the policy committee analysis for a full discussion  
          of this bill.


           Analysis Prepared by  :    Stella Choe / PUB. S. / (916) 319-3744 


                                                                FN: 0004695