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<ns0:Id>20250AB__192299INT</ns0:Id>
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<ns0:Action>
<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-12</ns0:ActionDate>
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<ns0:SessionYear>2025</ns0:SessionYear>
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<ns0:MeasureNum>1922</ns0:MeasureNum>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Assembly Member Lowenthal</ns0:AuthorText>
<ns0:Authors>
<ns0:Legislator>
<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
<ns0:House>ASSEMBLY</ns0:House>
<ns0:Name>Lowenthal</ns0:Name>
</ns0:Legislator>
</ns0:Authors>
<ns0:Title> 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. </ns0:Title>
<ns0:RelatingClause>incarcerated persons</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Restraint of incarcerated persons. </ns0:Subject>
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<ns0:DigestText>
<html:p>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. </html:p>
<html:p>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 care. If there is an immediate 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 immediate physical threat while the incarcerated patient is in the hospital. </html:p>
<html:p>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.</html:p>
<html:p>This bill would prohibit juveniles and incarcerated persons admitted to a hospital from being restrained by the use of mechanical restraints while receiving care, as defined. 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 if there is an immediate physical threat while the incarcerated patient is in the hospital. By placing new requirements on local correctional facility and juvenile facility staff, this bill would impose a state-mandated local program. </html:p>
<html:p>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.</html:p>
<html:p>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.</html:p>
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<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
<ns0:BillSection id="id_1C19C717-712C-42E9-811F-2A93C2E03E8C">
<ns0:Num>SECTION 1.</ns0:Num>
<ns0:Content>
<html:p>The Legislature finds and declares all of the following: </html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
Incarceration is associated with significant adverse health outcomes, including evidence that each year of incarceration is correlated with an approximate two-year reduction in life expectancy. The Legislature further finds that Black, indigenous, and other people of color are disproportionately represented among the approximately 2,100,000 individuals incarcerated in jails and prisons in the United States, compounding existing health inequities.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Incarcerated patients are routinely shackled in hospitals outside their correctional facility when receiving medical care.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
According to the American Public Health Association, shackling is a “violent practice” with detrimental effects on both patients and health care providers.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
The American Medical Association reported that the shackling of incarcerated pregnant people is a “barbaric” practice that inflicts pain and humiliation on patients.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
In Estelle v. Gamble (1976) 429 U.S. 97, the United States Supreme Court ruled that willful neglect of serious medical needs was a violation of the Eighth Amendment right to be free from cruel and unusual punishment. Since then, federal courts have condemned shackling of incarcerated pregnant patients as a violation of the Eighth Amendment of the United States Constitution.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
In 2012, California became a national leader in the
movement to ban shackling for incarcerated pregnant people by enacting Assembly Bill 2530 (Chapter 726 of the Statutes of 2012). Existing law permits the use of waist chains or leg restraints, and requires handcuffs to be applied in front for incarcerated pregnant people, and transport restraints are limited to front-handcuffing unless the person is in labor. Any restraint ordered by a licensed clinician is required to be documented in the medical file.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
Restricting shackling for incarcerated pregnant people received overwhelmingly bipartisan support in the California Legislature.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
Shackling impedes medical care and increases the patient’s health risks. It limits clinicians’ ability to perform examinations, delays positioning during seizures, increases the risk of falls, contributes to physical deconditioning, and elevates the likelihood of blood clots. Shackles can also
interfere with surgical procedures, diminish therapeutic rapport between patients and clinicians, and restrict the provision of compassionate end-of-life care.
</html:p>
<html:p>
(i)
<html:span class="EnSpace"/>
Shackling incarcerated patients exacerbates clinicians’ implicit biases, reduces empathy, and contributes to diagnostic skepticism, thereby undermining the quality and equity of medical care.
</html:p>
<html:p>
(j)
<html:span class="EnSpace"/>
The state should follow suit for all incarcerated patients in outside hospitals who are transferred for serious or complex medical care and for whom shackling poses documented risks of injury, clinical interference, and worsened health outcomes in order to prevent avoidable harm, ensure the safety of patients and others, and promote access to adequate, dignified, and humane medical care.
</html:p>
<html:p>
(k)
<html:span class="EnSpace"/>
The Legislature further finds that hospitals are governed by federal
standards regulating medical restraints, which require use of restraints only when necessary, the least restrictive means, and ongoing reassessment. Evidence shows that escape attempts from hospitals are exceedingly rare, making routine correctional shackling unnecessary to ensure safety.
</html:p>
<html:p>
(
<html:i>l</html:i>
)
<html:span class="EnSpace"/>
Existing law authorizes the Secretary of the Department of Corrections and Rehabilitation to prescribe and amend rules and regulations for the administration of prisons.
</html:p>
<html:p>
(m)
<html:span class="EnSpace"/>
Existing regulations governing health care transfers require continuity of care when incarcerated patients are transferred to medical facilities outside of the Department of Corrections and Rehabilitation.
</html:p>
<html:p>
(n)
<html:span class="EnSpace"/>
This bill would extend and expand existing limits on the use of shackles, including handcuffs, except during transport, to medically
vulnerable incarcerated patients once they have been admitted to an outside hospital.
</html:p>
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<ns0:Num>SEC. 2.</ns0:Num>
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Section 2652.6 is added to the
<ns0:DocName>Penal Code</ns0:DocName>
, to read:
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<ns0:LawSection id="id_C5D320CF-BD6F-47FB-ABCD-F7BCDA1C60FE">
<ns0:Num>2652.6.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
An incarcerated person who is admitted to a hospital shall not be restrained by the use of mechanical restraints while receiving care.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
If there is an immediate 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, and mechanical restraints shall not be used by state correctional facility staff.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
Nothing in this section shall be interpreted to require restraints when restraints are not otherwise required pursuant to a statute, regulation, or state correctional facility policy.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
For the purposes of this section, the following definitions shall apply:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
“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.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
“Immediate physical threat” means an imminent risk of harm to the incarcerated person, medical staff, or other individuals.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
“Incarcerated patient” means an individual who is incarcerated in a state correctional facility and needs to be admitted to a hospital for medical care.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
“Hospital” means a general acute care hospital as defined in Section 1250 of the Health and Safety Code.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
“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, waist chains, and leg irons.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
“While receiving care” means while receiving medical services, including, but not limited to, medical examinations, diagnostic procedures, treatments, surgical procedures, postoperative recovery, hospice care, and all other time spent within a hospital facility as an admitted patient.
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<ns0:Num>SEC. 3.</ns0:Num>
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Section 6030 of the
<ns0:DocName>Penal Code</ns0:DocName>
is amended to read:
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<ns0:LawSection id="id_B402DCA2-988C-4EB5-91D4-9E2FCC606363">
<ns0:Num>6030.</ns0:Num>
<ns0:LawSectionVersion id="id_B9B7A6AA-3F2C-4D41-B6BE-D75C2520A92D">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
The standards shall also
include requirements relating to the acquisition, storage, labeling, packaging, and dispensing of drugs.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
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:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
A balanced, nutritious diet approved by a doctor.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Prenatal and postpartum information and health care, including, but not limited to, access to necessary vitamins as recommended by a doctor.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Information pertaining to childbirth education and infant care.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
A dental cleaning while in a state facility.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
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 care.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
If there is an immediate 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, and that mechanical restraints may not be used by local correctional facility staff.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
For the purposes of this subdivision, the following definitions shall apply:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
“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.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
“Immediate physical threat” means an imminent risk of harm to the incarcerated person, medical staff, or other individuals.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
“Incarcerated patient” means an individual who is incarcerated in a local correctional facility and needs to be admitted to a hospital for medical care.
</html:p>
<html:p>
(D)
<html:span class="EnSpace"/>
“Hospital” means a general acute care hospital as defined in Section 1250 of the Health and Safety Code.
</html:p>
<html:p>
(E)
<html:span class="EnSpace"/>
“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, waist chains, and leg irons.
</html:p>
<html:p>
(F)
<html:span class="EnSpace"/>
“While receiving care” means while receiving medical services, including, but not limited to, medical examinations, diagnostic procedures, treatments, surgical procedures, postoperative recovery, hospice care, and all other time spent within a hospital facility as an admitted patient.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
In establishing minimum standards, the board shall seek the advice of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
For health and sanitary conditions:
</html:p>
<html:p>The State Department of Public Health, physicians, psychiatrists, local public health officials, and other interested persons.</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
For fire and life safety:
</html:p>
<html:p>The State Fire Marshal, local fire officials, and other interested persons.</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
For security, rehabilitation programs, recreation, and treatment of persons confined in correctional facilities:
</html:p>
<html:p>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.</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
For personnel training:
</html:p>
<html:p>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.</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
For female inmates and pregnant inmates in local adult and juvenile facilities and incarcerated patients receiving care in hospitals:
</html:p>
<html:p>The California State Sheriffs’ Association and Chief
Probation Officers’ Association of California, and other interested persons.</html:p>
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<ns0:Num>SEC. 4.</ns0:Num>
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Section 210.6 of the
<ns0:DocName>Welfare and Institutions Code</ns0:DocName>
is amended to read:
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<ns0:LawSection id="id_EC4994C6-9782-4A28-ADB5-236923CED4C7">
<ns0:Num>210.6.</ns0:Num>
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<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
This subdivision does not apply to mechanical restraints used by medical care providers in the course of medical care or transportation.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The burden to establish the need for mechanical restraints pursuant to paragraph (1) is on the prosecution.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
A juvenile who is admitted to a hospital shall not be restrained by mechanical restraints while receiving care.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
If there is an immediate 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.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
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.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
For the purposes of this section, the following definitions shall apply:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
“Hospital” means a general acute care hospital as defined in Section 1250 of the Health and Safety Code.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
“Immediate physical threat” means an imminent risk of harm to the juvenile, medical staff, or other individuals.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
“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.
</html:p>
<html:p>
(D)
<html:span class="EnSpace"/>
“Juvenile patient” means an individual who is incarcerated in a local correctional facility and needs to be admitted to a hospital for medical care.
</html:p>
<html:p>
(E)
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“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, waist chains, and leg irons.
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<html:p>
(F)
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“While receiving care” means while receiving medical services, including, but not limited to, medical examinations, diagnostic procedures, treatments, surgical procedures, postoperative
recovery, hospice care, and all other time spent within a hospital facility as an admitted patient.
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<ns0:BillSection id="id_3F19B272-9695-43FF-9C78-024038071700">
<ns0:Num>SEC. 5.</ns0:Num>
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<html:p>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.</html:p>
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