BILL ANALYSIS                                                                                                                                                                                                    �



                                                                            



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                                 UNFINISHED BUSINESS


          Bill No:  SB 1135
          Author:   Jackson (D), et al.
          Amended:  8/11/14
          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

           SENATE FLOOR :  36-0, 5/27/14
          AYES:  Anderson, Beall, Berryhill, Block, Cannella, Corbett,  
            Correa, De Le�n, DeSaulnier, Evans, Fuller, Gaines, Galgiani,  
            Hancock, Hernandez, Hill, Hueso, Huff, Jackson, Knight, Lara,  
            Leno, Lieu, Mitchell, Monning, Morrell, Nielsen, Padilla,  
            Pavley, Roth, Steinberg, Torres, Vidak, Walters, Wolk, Wyland
          NO VOTE RECORDED:  Calderon, Liu, Wright, Yee

           ASSEMBLY FLOOR  :  77-0, 8/18/14 - See last page for vote


           SUBJECT  :    Inmates:  sterilization

           SOURCE  :     Justice Now


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           DIGEST  :    This bill prohibits sterilization for the purpose of  
          birth control of an individual under the control of the  
          Department of Corrections and Rehabilitation (CDCR), as  
          specified.  Requires CDCR to publish data on its Internet Web  
          site related to the number of sterilizations performed, as  
          specified.

           Assembly Amendments  add to the means under which an inmate under  
          the control of CDCR is prohibited from being sterilized, clarify  
          the exceptions for allowing sterilization, and revise the  
          reporting requirements. 

           ANALYSIS  :    Existing statutory law:

          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.


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          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:

             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,  
            salpingectomy, 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,

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             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:

               1)     Less invasive measures to address the medical need  
                 are non-existent, are refused by the individual, or are  
                 first attempted and deemed unsuccessful by the  
                 individual, in consultation with his/her medical  
                 provider;

               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  
                 confinement of the individual conducts an in-person  
                 consultation with the individual 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 to publish an annual report on its Internet Web  
            site, data related to the number of sterilizations performed,  
            disaggregated by race, age, medical justification, and method  
            of sterilization, including, but not limited to, hysterectomy  
            and oophorectomy.  Specifies that each county jail or other  
            institution of confinement is required, if a sterilization  
            procedure is performed on one or more individuals under its  
            control, to annually submit to the Board of State and  

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            Community Corrections data related to the number of  
            sterilizations performed, disaggregated by race, age, medical  
            justification, and method of  sterilization.  Requires the  
            Board of State and Community Corrections to annually publish  
            this data on its Internet Web site.

          3.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 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  
               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  

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               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

          According to the Assembly Appropriations Committee:

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

           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. 

           SUPPORT  :   (Verified  8/18/14)

          Justice Now (source) 
          All of Us or None
          ACLU
          Berkeley Law Center on Reproductive Rights and Justice
          Black And Pink, San Diego
          CA Correctional Health Care Services

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          CA Partnership to End Domestic Violence
          California Catholic Conference, Inc.
          Californians United for a Responsible Budget
          Critical Resistance
          Friends Committee on Legislation
          Legal Services for Women Prisoners with Children
          National Asian Pacific Islander Women's Forum
          Planned Parenthood Affiliates of California, 
          Sister Song Women of Color Reproductive Justice Collective
          The Women's Foundation
          Women Fight Back
          Women With a Vision
          Women's Health Specialists

           OPPOSITION  :    (Verified  8/18/14)

          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.  


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           ARGUMENTS IN OPPOSITION  :    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.  
           

           ASSEMBLY FLOOR  :  77-0, 8/18/14
          AYES: Achadjian, Alejo, Allen, Ammiano, Bigelow, Bloom,  
            Bocanegra, Bonilla, Bonta, Bradford, Brown, Buchanan, Ian  
            Calderon, Campos, Chau, Ch�vez, Chesbro, Conway, Cooley,  
            Dababneh, Dahle, Daly, Dickinson, Donnelly, Eggman, Fong, Fox,  
            Frazier, Beth Gaines, Garcia, Gatto, Gonzalez, Gordon, Gorell,  
            Gray, Grove, Hagman, Hall, Harkey, Roger Hern�ndez, Holden,  
            Jones, Jones-Sawyer, Levine, Linder, Logue, Lowenthal,  
            Maienschein, Mansoor, Medina, Melendez, Muratsuchi, Nazarian,  
            Nestande, Olsen, Pan, Patterson, Perea, John A. P�rez, V.  
            Manuel P�rez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,  
            Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Waldron,  
            Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
          NO VOTE RECORDED: Gomez, Mullin, Vacancy


          JL:nl  8/18/14   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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