Restraint of incarcerated persons., the official text

An act to amend Section 6030 of, and to add Section 2652.6 to, the Penal Code, and to amend Section 210.6 of the Welfare and Institutions Code, relating to incarcerated persons.

LEGISLATIVE COUNSEL'S DIGEST

Existing law establishes the Board of State and Community Corrections and declares that the mission of the board is to provide statewide leadership, coordination, and technical assistance to promote effective state and local efforts and partnerships in California’s adult and juvenile criminal justice system consistent with the statewide goal of improved public safety through cost-effective, promising, and evidence-based strategies for managing criminal justice populations. Existing law requires the board to establish minimum standards for local correctional facilities, including the safety of incarcerated individuals, and to biennially review and make appropriate revisions to those standards.
This bill would require the board’s standards to prohibit an incarcerated patient who is admitted to a hospital from being restrained by the use of mechanical restraints, as defined, while receiving an advanced level of medical services, as defined, except as specified. If there is an imminent physical threat while the incarcerated patient is in the hospital, the bill would require the standards to provide that a hospital may initiate their medical restraint process, as specified, and would prohibit the use of mechanical restraints by local correctional facility staff if there is an imminent physical threat while the incarcerated patient is in the hospital. The bill would authorize the use of mechanical restraints by state correctional facility staff or juvenile facility staff if an incarcerated adult or juvenile patient attempts to escape from the hospital, subject to certain requirements.
Existing law prohibits the application of restraints to incarcerated pregnant persons, as specified. Existing law requires a pregnant person who is incarcerated in a prison to be temporarily taken to a hospital outside the prison for the purpose of giving childbirth and to be transported in the least restrictive way possible and in accordance with the above-described provisions. Existing law also specifies the circumstances during which a juvenile may be placed in mechanical restraints, including during transportation between facilities.
This bill would prohibit juveniles and incarcerated persons admitted to a hospital from being restrained by the use of mechanical restraints while receiving an advanced level of medical services, as defined. If there is an imminent physical threat while the incarcerated patient is in the hospital, the bill would authorize a hospital to initiate its medical restraint process, as specified, and would prohibit the use of mechanical restraints by state correctional facility staff or juvenile facility staff. The bill would authorize the use of mechanical restraints by state correctional facility staff or juvenile facility staff if an incarcerated adult or juvenile patient attempts to escape from the hospital, subject to certain requirements. By placing new requirements on local correctional facility and juvenile facility staff, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

The people of the State of California do enact as follows:

SECTION 1.
Section 2652.6 is added to the Penal Code, to read:
2652.6.
(a) Except as otherwise provided in this section, an incarcerated person who is admitted to a hospital shall not be restrained by the use of mechanical restraints while receiving an advanced level of medical services.
(b) (1) If there is an imminent physical threat while the incarcerated patient is in the hospital, the hospital may initiate its medical restraint process, as regulated by the federal Centers for Medicare and Medicaid Services (CMS), and mechanical restraints shall not be used by state correctional facility staff.
(2) The use of medical restraints shall be ordered by appropriate clinical staff, documented in the incarcerated patient’s medical chart, and include the time and date of initiation and the name and title of the person authorizing the restraint.
(c) If an incarcerated patient has attempted to escape from the hospital, correctional facility staff may administer the least restrictive mechanical restraints necessary, consistent with legitimate safety and security considerations and subject to the following requirements:
(1) Mechanical restraints applied pursuant to this subdivision shall be permitted only for the duration necessary to prevent another escape attempt, and shall be removed as soon as the escape attempt has been contained and the correctional facility staff have determined the incarcerated patient no longer presents an imminent risk of escape.
(2) If mechanical restraints are applied pursuant to this subdivision, correctional facility staff shall document the specific conduct constituting the escape attempt, the time mechanical restraints were applied, the justification for their continued use, and the name of the staff administering mechanical restraints.
(3) The continued use of mechanical restraints under this subdivision shall be reassessed every four hours to determine whether their continued use complies with this subdivision.
(4) This subdivision does not authorize the routine or precautionary use of mechanical restraints based solely on custody classification, criminal history, or generalized assumptions regarding escape risk.
(d) This section shall not be interpreted to require restraints when restraints are not otherwise required pursuant to a statute, regulation, or state correctional facility policy.
(e) This section shall not apply during the transportation of an incarcerated person to or from a hospital. Any mechanical restraint of an incarcerated person during transport between clinical settings shall be the least restrictive means necessary, consistent with safety considerations.
(f) For the purposes of this section, the following definitions shall apply:
(1) “Admitted” means the patient’s physician or other qualified practitioner has ordered admission based on the expectation that the patient will require medically necessary hospital care spanning at least two midnights, consistent with applicable federal CMS admission guidelines.
(2) “Correctional facility staff” means a Department of Corrections and Rehabilitation staff member from the state correctional facility charged with overseeing an incarcerated patient admitted to outside hospitals for medical care.
(3) “Imminent physical threat” means violent or self-destructive behavior that jeopardizes the immediate physical safety of the patient, a staff member, or others.
(4) “Incarcerated patient” means an individual who is incarcerated in a state correctional facility and needs to be admitted to a hospital for medical care.
(5) “Hospital” means a general acute care hospital as defined in Section 1250 of the Health and Safety Code.
(6) “Mechanical restraints” means the use of all devices not ordered by medical providers that are intended to restrict the movement of the incarcerated person, including, but not limited to, metal cuffs around the wrists or ankles, zip ties, waist chains, and leg irons.
(7) (A) “While receiving an advanced level of medical services” means receiving at least one of the following interventions during admission:
(i) Mechanical ventilation.
(ii) Medical sedation.
(iii) Surgery.
(iv) Vasopressors.
(v) Medical paralysis.
(vi) Chemotherapy.
(vii) Dialysis.
(viii) Comfort measures.
(ix) Peripartum management or postpartum management.
(B) “While receiving an advanced level of medical services” does not include medical services received in an emergency department of a hospital.

SEC. 2.
Section 6030 of the Penal Code is amended to read:
6030.
(a) The Board of State and Community Corrections shall establish minimum standards for local correctional facilities. The board shall review those standards biennially and make any appropriate revisions.
(b) The standards shall include, but not be limited to, the following areas: health and sanitary conditions, fire and life safety, security, rehabilitation programs, recreation, treatment of persons confined in local correctional facilities, and personnel training.
(c) The standards shall require that at least one person on duty at the facility is knowledgeable in the area of fire and life safety procedures.
(d) The standards shall also include requirements relating to the acquisition, storage, labeling, packaging, and dispensing of drugs.
(e) The standards shall require that inmates who are received by the facility while they are pregnant be notified, orally or in writing, of and provided all of the following:
(1) A balanced, nutritious diet approved by a doctor.
(2) Prenatal and postpartum information and health care, including, but not limited to, access to necessary vitamins as recommended by a doctor.
(3) Information pertaining to childbirth education and infant care.
(4) A dental cleaning while in a state facility.
(f) The standards shall provide that a woman known to be pregnant or in recovery after delivery shall not be restrained, except as provided in Section 3407. The board shall develop standards regarding the restraint of pregnant women at the next biennial review of the standards after the enactment of the act amending this subdivision and shall review the individual facility’s compliance with the standards.
(g) (1) Except as otherwise provided in this section, the standards shall also provide that an incarcerated patient who is admitted to a hospital shall not be restrained by the use of mechanical restraints while receiving an advanced level of medical services.
(2) If there is an imminent physical threat while the incarcerated patient is in the hospital, the standards shall provide that the hospital may initiate their medical restraint process, as regulated by the federal Centers for Medicare and Medicaid Services (CMS), and that mechanical restraints may not be used by local correctional facility staff.
(3) The standards shall require that any use of medical restraints shall be ordered by appropriate clinical staff, documented in the incarcerated patient’s medical chart, and include the time and date of initiation and the name and title of the person authorizing the restraint.
(4) The standards shall provide that if an incarcerated patient attempts to escape from the hospital, correctional facility staff may administer the least restrictive mechanical restraints necessary, consistent with legitimate safety and security considerations and subject to the following requirements:
(A) Mechanical restraints applied pursuant to this paragraph shall be permitted only for the duration necessary to prevent another escape attempt, and shall be removed as soon as the escape attempt has been contained and the correctional facility staff have determined the incarcerated patient no longer presents an imminent risk of escape.
(B) If mechanical restraints are applied pursuant to this paragraph, correctional facility staff shall document the specific conduct constituting the escape attempt, the time mechanical restraints were applied, the justification for their continued use, and the name of the staff administering mechanical restraints.
(C) The continued use of mechanical restraints under this paragraph shall be reassessed every four hours to determine whether their continued use complies with this paragraph.
(D) This paragraph does not authorize the routine or precautionary use of mechanical restraints based solely on custody classification, criminal history, or generalized assumptions regarding escape risk.
(5) Nothing in this subdivision shall be interpreted to require restraints when restraints are not otherwise required pursuant to a statute, regulation, or local correctional facility policy.
(6) The standards required by this subdivision shall not apply during the transportation of an incarcerated person to or from a hospital. Any use of mechanical restraints on an incarcerated person during transport between clinical settings shall be the least restrictive means necessary, consistent with safety considerations.
(7) For the purposes of this subdivision, the following definitions shall apply:
(A) “Admitted” means the patient’s physician or other qualified practitioner has ordered admission based on the expectation that the patient will require medically necessary hospital care spanning at least two midnights, consistent with applicable federal CMS admission guidelines.
(B) “Local correctional facility staff” means a local correctional facility staff member from the institution charged with overseeing an incarcerated patient admitted to outside hospitals for medical care.
(C) “Imminent physical threat” means violent or self-destructive behavior that jeopardizes the immediate physical safety of the patient, a staff member, or others.
(D) “Incarcerated patient” means an individual who is incarcerated in a local correctional facility and needs to be admitted to a hospital for medical care.
(E) “Hospital” means a general acute care hospital as defined in Section 1250 of the Health and Safety Code.
(F) “Mechanical restraints” means all devices not ordered by medical providers that are intended to restrict the movement of the incarcerated person, including, but not limited to, metal cuffs around the wrists or ankles, zip ties, waist chains, and leg irons.
(G) (i) “While receiving an advanced level of medical services” means receiving at least one of the following interventions during their admission:
(I) Mechanical ventilation.
(II) Medical sedation.
(III) Surgery.
(IV) Vasopressors.
(V) Medical paralysis.
(VI) Chemotherapy.
(VII) Dialysis.
(VIII) Comfort measures.
(IX) Peripartum management or postpartum management.
(ii) “While receiving an advanced level of medical services” does not include medical services received in an emergency department of a hospital.
(h) In establishing minimum standards, the board shall seek the advice of the following:
(1) For health and sanitary conditions:
The State Department of Public Health, physicians, psychiatrists, local public health officials, and other interested persons.
(2) For fire and life safety:
The State Fire Marshal, local fire officials, and other interested persons.
(3) For security, rehabilitation programs, recreation, and treatment of persons confined in correctional facilities:
The Department of Corrections and Rehabilitation, state and local juvenile justice commissions, state and local correctional officials, experts in criminology and penology, and other interested persons.
(4) For personnel training:
The Commission on Peace Officer Standards and Training, psychiatrists, experts in criminology and penology, the Department of Corrections and Rehabilitation, state and local correctional officials, and other interested persons.
(5) For female inmates and pregnant inmates in local adult and juvenile facilities and incarcerated patients receiving care in hospitals:
The California State Sheriffs’ Association and Chief Probation Officers’ Association of California, and other interested persons.

SEC. 3.
Section 210.6 of the Welfare and Institutions Code is amended to read:
210.6.
(a) (1) Mechanical restraints, including, but not limited to, handcuffs, chains, irons, straitjackets or cloth or leather restraints, or other similar items, may be used on a juvenile detained in or committed to a local secure juvenile facility, camp, ranch, or forestry camp, as established pursuant to Sections 850 and 881, during transportation outside of the facility only upon a determination made by the probation department, in consultation with the transporting agency, that the mechanical restraints are necessary to prevent physical harm to the juvenile or another person or due to a substantial risk of flight.
(2) If a determination is made that mechanical restraints are necessary, the least restrictive form of restraint shall be used consistent with the legitimate security needs of each juvenile.
(3) A county probation department that chooses to use mechanical restraints other than handcuffs on juveniles shall establish procedures for the documentation of their use, including the reasons for the use of those mechanical restraints.
(4) This subdivision does not apply to mechanical restraints used by medical care providers in the course of medical care or transportation.
(b) (1) Mechanical restraints may only be used during a juvenile court proceeding if the court determines that the individual juvenile’s behavior in custody or in court establishes a manifest need to use mechanical restraints to prevent physical harm to the juvenile or another person or due to a substantial risk of flight.
(2) The burden to establish the need for mechanical restraints pursuant to paragraph (1) is on the prosecution.
(3) If the court determines that mechanical restraints are necessary, the least restrictive form of restraint shall be used and the reasons for the use of mechanical restraints shall be documented in the record.
(d) (1) Except as otherwise provided in this section, a juvenile patient who is admitted to a hospital shall not be restrained by mechanical restraints while receiving an advanced level of medical services.
(2) If there is an imminent physical threat while the juvenile patient is in the hospital, the hospital may initiate its medical restraint process, as regulated by the federal Centers for Medicare and Medicaid Services, and mechanical restraints may not be used by juvenile correctional facility staff.
(3) The use of medical restraints shall be ordered by appropriate clinical staff, documented in the juvenile patient’s medical chart, and include the time and date of initiation and the name and title of the person authorizing the restraint.
(4) If a juvenile patient attempts to escape from the hospital, correctional facility staff may administer the least restrictive mechanical restraints necessary, consistent with legitimate safety and security considerations and subject to the following requirements:
(A) Mechanical restraints applied pursuant to this paragraph shall be permitted only for the duration necessary to prevent another escape attempt, and shall be removed as soon as the escape attempt has been contained and the correctional facility staff have determined the incarcerated patient no longer presents an imminent risk of escape.
(B) If mechanical restraints are applied pursuant to this paragraph, correctional facility staff shall document the specific conduct constituting the escape attempt, the time mechanical restraints were applied, the justification for their continued use, and the name of the staff administering mechanical restraints.
(C) The continued use of mechanical restraints under this subdivision shall be reassessed every two hours to determine whether their continued use complies with this paragraph.
(D) This paragraph does not authorize the routine or precautionary use of mechanical restraints based solely on custody classification, criminal history, or generalized assumptions regarding escape risk.
(5) Nothing in this subdivision shall be interpreted to require restraints when restraints are not otherwise required pursuant to a statute, regulation, or juvenile facility policy.
(6) Except as otherwise provided in paragraph (7), the provisions of subdivision (a) shall apply to the transportation of a juvenile patient between the local secure juvenile facility, camp, ranch, or forestry camp, and the hospital.
(7) Any mechanical restraint of a juvenile patient during transport between clinical settings shall be the least restrictive means necessary and consistent with legitimate safety and security considerations in the discretion of transportation staff.
(8) For the purposes of this section, the following definitions shall apply:
(A) “Admitted” means the patient’s physician or other qualified practitioner has ordered admission based on the expectation that the patient will require medically necessary hospital care spanning at least two midnights, consistent with applicable federal CMS admission guidelines.
(B) “Hospital” means a general acute care hospital as defined in Section 1250 of the Health and Safety Code.
(C) “Imminent physical threat” means violent or self-destructive behavior that jeopardizes the immediate physical safety of the patient, a staff member, or others.
(D) “Juvenile facility staff” means a staff member from the local secure juvenile facility, camp, ranch, or forestry camp charged with overseeing an incarcerated patient admitted to outside hospitals for medical care.
(E) “Juvenile patient” means a person who is under the maximum age of juvenile court jurisdiction and who is confined in a Division of Juvenile Justice facility, a county- or city-operated juvenile facility, or any other local or state facility used for the confinement of minors or wards, including, but not limited to, juvenile halls, camps, ranches, or secure youth treatment facilities.
(F) “Mechanical restraints” means all devices not ordered by medical providers that are intended to restrict the movement of the incarcerated person, including, but not limited to, metal cuffs around the wrists or ankles, zip ties, waist chains, and leg irons.
(G) (i) “While receiving an advanced level of medical services” means receiving at least one of the following interventions during their admission:
(I) Mechanical ventilation.
(II) Medical sedation.
(III) Surgery.
(IV) Vasopressors.
(V) Medical paralysis.
(VI) Chemotherapy.
(VII) Dialysis.
(VIII) Comfort measures.
(IX) Peripartum management or postpartum management.
(ii) “While receiving an advanced level of medical services” does not include medical services received in an emergency department of a hospital.

SEC. 4.
If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.