,i #aahth ,,congress #ast ,session ,h4 ,r4 #ihb ,,in ,,the ,,house ,,of ,,representatives ,february #aj1 #bjbc,ms4 ,kamlager-,dove 7for herself and ,mrs4 ,lesko7 introduced the following bill2 which was referred to the ,committee on the ,judiciary1 and in addition to the ,committee on the ,budget1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to address the health needs of incarcerated women related to pregnancy and childbirth1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,pregnant ,women in ,custody ,act4 #b4 ,definitions ,in this ,act3 7#a7 ,in custody ,the term in custody1 with respect to an individual1 means that the individual is under the supervision of a ,federal1 ,state1 ,tribal1 or local correctional facility1 including a pretrial1 juvenile1 medical1 or mental health facility and a facility operated under a contract with the ,federal ,government or a ,state1 ,tribal1 or local government4 7#b7 ,other pregnancy outcome ,the term other pregnancy outcome means a pregnancy that ends in stillbirth1 miscarriage1 or ectopic pregnancy4 7#c7 ,postpartum recovery ,the term postpartum recovery has the meaning given that term in section #djea7;c7 of title #ah1 ,united ,states ,code1 as added by this ,act4 7#d7 ,restraints ,the term restraints means any physical or mechanical device used to control the movement of an incarcerated pregnant woman's body1 limbs1 or both4 7#e7 ,restrictive housing ,the term restrictive housing has the meaning given that term in section #dcbb of title #ah1 ,united ,states ,code1 as added by this ,act4 #c4 ,data collection 7a7 ,in general ,beginning not later than #a year after the date of enactment of this ,act1 pursuant to the authority under section #cjb of title ,i of the ,omnibus ,crime ,control and ,safe ,streets ,act of #aifh 7#cd ,u4,s4,c4 #ajacb71 the ,director of the ,bureau of ,justice ,statistics shall include in the ,national ,prisoner ,statistics ,program and ,annual ,survey of ,jails statistics relating to the health needs of incarcerated pregnant women in the criminal justice system at the ,federal1 ,state1 ,tribal1 and local levels1 including-- 7#a7 demographic and other information about incarcerated women who are pregnant1 in labor1 or in postpartum recovery1 including the race1 ethnicity1 and age of the woman2 7#b7 the provision of pregnancy care and services provided for such women1 including-- 7,a7 whether prenatal1 delivery1 and post-delivery check-up visits were scheduled and provided2 7,b7 whether a social worker1 psychologist1 doula or other support person was offered and provided during pregnancy and delivery and post-delivery2 7,c7 whether a pregnancy or parenting program was offered and provided during pregnancy2 7,d7 whether a nursery or residential program to keep mothers and infants together post-delivery was offered and whether such a nursery or residential program was provided2 7,e7 the number of days the mother stayed in the hospital post-delivery2 7,f7 the number of days the infant remained with the mother post-delivery2 and 7,g7 the number of days the infant remained in the hospital after the mother was discharged2 7#c7 the location of the nearest hospital with a licensed obstetrician-gynecologist in proximity to where the incarcerated pregnant woman is housed and the length of travel required to transport the woman2 7#d7 whether a written policy or protocol is in place-- 7,a7 to respond to unexpected childbirth1 labor1 deliveries1 or medical complications related to the pregnancies of incarcerated pregnant women2 and 7,b7 for incarcerated pregnant women experiencing labor or medical complications related to pregnancy outside of a hospital2 7#e7 the number of incarcerated women who are determined by a health care professional to have a high-risk pregnancy2 7#f7 the total number of incarcerated pregnant women and the number of incarcerated women who became pregnant while incarcerated2 7#g7 the number of incidents in which an incarcerated woman who is pregnant1 in labor1 or in postpartum recovery is placed in restrictive housing1 the reason for such restriction or placement1 and the circumstances under which each incident occurred1 including the duration of time in restrictive housing1 during-- 7,a7 pregnancy2 7,b7 labor2 7,c7 delivery2 7,d7 postpartum recovery2 and 7,e7 the #f-month period after delivery2 and 7#h7 the disposition of the custody of the infant post-delivery4 7b7 ,personally identifiable information ,data collected under this section may not contain any personally identifiable information of any incarcerated pregnant woman or woman in postpartum recovery4 #d4 ,care for federally incarcerated women related to pregnancy and childbirth 7a7 ,in general ,the ,director of the ,bureau of ,prisons shall ensure that appropriate services and programs1 as described in subsection 7b71 are provided to women in custody1 to address the health and safety needs of such women related to pregnancy and childbirth4 ,the warden of each ,bureau of ,prisons facility that houses women shall ensure that these services and programs are implemented for women in custody at that facility4 7b7 ,services and programs provided ,the services and programs described in this subsection are the following3 7#a7 ,access to complete appropriate health services for the life cycle of women ,the ,director of the ,bureau of ,prisons shall ensure that each woman of reproductive age in custody at a ,bureau of ,prisons facility-- 7,a7 has access to contraception and testing for pregnancy and sexually transmitted diseases1 upon request of any such woman2 and 7,b7 is administered a pregnancy test on the date on which the woman enters the facility1 which the woman may decline4 7#b7 ,compliance with protocols relating to health of a pregnant woman ,on confirmation of the pregnancy of a woman in custody by clinical diagnostics and assessment1 the chief health care professional of the ,bureau of ,prisons facility in which the woman is housed shall ensure that-- 7,a7 a summary of all appropriate protocols directly pertaining to the safety and well-being of the woman are provided to the woman2 7,b7 such protocols are complied with2 and 7,c7 such protocols include an assessment of undue safety risks and necessary changes to accommodate the woman where and when appropriate1 as it relates to-- 7i7 housing or transfer to a lower bunk for safety reasons2 7ii7 appropriate bedding or clothing to respond to the woman's changing physical requirements and the temperature in housing units2 7iii7 regular access to water and bathrooms2 7iv7 a diet that-- 7,i7 complies with the nutritional standards established by the ,secretary of ,agriculture and the ,secretary of ,health and ,human ,services in the ,dietary ,guidelines for ,americans report published pursuant to section #cja7;a77#c7 of the ,national ,nutrition ,monitoring and ,related ,research ,act of #aiij 7#g ,u4,s4,c4 #ecda7;a77#c772 and 7,,ii7 includes-- 7aa7 any appropriate dietary supplement1 including prenatal vitamins2 7bb7 timely and regular nutritious meals2 7cc7 additional caloric content in meals provided2 7dd7 a prohibition on withholding food from the woman or serving any food that is used as a punishment1 including nutraloaf or any food similar to nutraloaf that is not considered a nutritious meal2 and 7ee7 such other modifications to the diet of the woman as the ,director of the ,bureau of ,prisons determines to be necessary after consultation with the ,secretary of ,health and ,human ,services and consideration of such recommendations as the ,secretary may provide2 7v7 modified recreation and transportation1 in accordance with standards within the obstetrical and gynecological care community1 to prevent overexertion or prolonged periods of inactivity2 and 7vi7 such other changes to living conditions as the ,director of the ,bureau of ,prisons may require after consultation with the ,secretary of ,health and ,human ,services and consideration of such recommendations as the ,secretary may provide4 7#c7 ,education and support services 7,a7 ,pregnancy in custody ,a woman who is pregnant at intake or who becomes pregnant while in custody shall1 not later than #ad days after the pregnant woman notifies a ,bureau of ,prisons official of the pregnancy1 receive prenatal education1 counseling1 and birth support services provided by a provider trained to provide such services1 including-- 7i7 information about the parental rights of the woman1 including the right to place the child in kinship care1 and notice of the rights of the child2 7ii7 information about family preservation support services that are available to the woman2 7iii7 information about the nutritional standards referred to in paragraph 7#b77;,c77iv72 7iv7 information pertaining to the health and safety risks of pregnancy1 childbirth1 and parenting1 including postpartum depression2 7v7 information on breast-feeding1 lactation1 and breast health2 7vi7 appropriate educational materials1 resources1 and services related to pregnancy1 childbirth1 and parenting2 7vii7 information and notification services for incarcerated parents regarding the risk of debt repayment obligations associated with their child's participation in social welfare programs1 including assistance under any ,state program funded under part ,a of title ,,iv of the ,social ,security ,act 7#db ,u4,s4,c4 #fja et seq47 or benefits under the supplemental nutrition assistance program1 as defined in section #c of the ,food and ,nutrition ,act of #bjjh 7#g ,u4,s4,c4 #bjab71 or any ,state program carried out under that ,act2 and 7viii7 information from the ,office of ,child ,support ,enforcement of the ,department of ,health and ,human ,services regarding seeking or modifying child support while incarcerated1 including how to participate in the ,bureau of ,prison's ,inmate ,financial ,responsibility ,program under subpart ,b of part #ede of title #bh1 ,code of ,federal ,regulations 7or any successor program74 7,b7 ,birth while in custody or prior to custody ,a woman who1 while in custody or during the #f-month period immediately preceding intake1 gave birth or experienced any other pregnancy outcome shall receive counseling provided by a licensed or certified provider trained to provide such services1 including-- 7i7 information about the parental rights of the woman1 including the right to place the child in kinship care1 and notice of the rights of the child2 7ii7 information about family preservation support services that are available to the woman2 and 7iii7 postpartum health conditions4 7#d7 ,evaluations 7,a7 ,in general ,each woman in custody who is pregnant or whose pregnancy results in a birth or any other pregnancy outcome during the #f-month period immediately preceding intake or any time in custody thereafter shall be evaluated as soon as practicable after intake or confirmation of pregnancy through evidence-based screening and assessment for substance use disorders or mental health conditions1 including postpartum depression or depression related to pregnancy1 birth1 or any other pregnancy outcome or early child care4 7,b7 ,risk factors ,screening under subparagraph 7,a7 shall include identification of any of the following risk factors3 7i7 ,an existing mental or physical health condition or substance use disorder4 7ii7 ,being underweight or overweight4 7iii7 ,multiple births or a previous still birth4 7iv7 ,a history of preeclampsia4 7v7 ,a previous ,caesarean section4 7vi7 ,a previous miscarriage4 7vii7 ,being older than #ce or younger than #ae4 7viii7 ,being diagnosed with the human immunodeficiency virus1 hepatitis1 diabetes1 or hypertension4 7ix7 ,such other risk factors as the chief health care professional of the ,bureau of ,prisons facility that house the woman may determine to be appropriate4 7#e7 ,unexpected births rulemaking ,the ,director of the ,bureau of ,prisons shall provide services to respond to unexpected childbirth deliveries1 labor complications1 and medical complications related to pregnancy if a woman in custody is unable to access a hospital in a timely manner in accordance with rules promulgated by the ,attorney ,general1 which shall be promulgated not later than #ahj days after the date of enactment of this ,act4 7#f7 ,treatment ,the ,director of the ,bureau of ,prisons shall use best efforts to provide a woman in custody who is pregnant and diagnosed with having a substance use disorder or a mental health disorder with appropriate evidence-based treatment4 #e4 ,use of restrictive housing on incarcerated pregnant women during pregnancy1 labor1 and postpartum recovery prohibited 7a7 ,in general ,section #dcbb of title #ah1 ,united ,states ,code1 is amended to read as follows3 #dcbb4 ,use of restrictive housing on incarcerated women during the period of pregnancy1 labor1 and postpartum recovery prohibited 7a7 ,prohibition ,except as provided in subsection 7b71 during the period beginning on the date on which pregnancy is confirmed by a health care professional and ending not earlier than #ab weeks after delivery1 an incarcerated woman in the custody of the ,bureau of ,prisons1 or in the custody of the ,united ,states ,marshals ,service pursuant to section #djhf1 shall not be held in restrictive housing4 7b7 ,exceptions 7#a7 ,restrictive housing ,subject to paragraph 7#d71 the prohibition under subsection 7a7 relating to restrictive housing shall not apply if the ,director of the ,bureau of ,prisons or a senior ,bureau of ,prisons official overseeing women's health and services1 in consultation with senior officials in health services1 makes an individualized determination that restrictive housing is required as a temporary response to behavior that poses a serious and immediate risk of physical harm4 7#b7 ,review ,the official who makes a determination under subparagraph 7,a7 shall review such determination daily for the purpose of removing an incarcerated woman as quickly as feasible from restrictive housing4 7#c7 ,restrictive housing plan ,the official who makes a determination under subparagraph 7,a7 shall develop an individualized plan to move an incarcerated woman to less restrictive housing within a reasonable amount of time4 7#d7 ,prohibition on solitary confinement ,an incarcerated woman who is placed in restrictive housing under this subsection may not be placed in solitary confinement if the incarcerated woman is in her third trimester4 7c7 ,reports 7#a7 ,report to directors and health care professional after placement in restrictive housing ,not later than #cj days after the date on which an incarcerated woman is placed in restrictive housing under subsection 7b71 the applicable official identified in subsection 7b77#a71 correctional officer1 or ,united ,states ,marshal shall submit to the ,director of the ,bureau of ,prisons or the ,director of the ,united ,states ,marshals ,service1 as applicable1 and to the health care professional responsible for the health and safety of the woman1 a written report which describes the facts and circumstances surrounding the restrictive housing placement1 and includes the following3 7,a7 ,the reasoning upon which the determination for the placement was made4 7,b7 ,the details of the placement1 including length of time of placement and how frequently and how many times the determination was made subsequent to the initial determination to continue the restrictive housing placement4 7,c7 ,a description of all attempts to use alternative interventions and sanctions before the restrictive housing was used4 7,d7 ,any resulting physical effects on the woman observed by or reported by the health care professional responsible for the health and safety of the woman4 7,e7 ,strategies the facility is putting in place to identify more appropriate alternative interventions should a similar situation arise again4 7#b7 ,report to congress ,not later than #ahj days after the date of enactment of the ,pregnant ,women in ,custody ,act1 and every #ahj days thereafter for a period of #aj years1 the ,attorney ,general shall submit to the ,committee on the ,judiciary of the ,senate and the ,committee on the ,judiciary of the ,house of ,representatives a report on the placement of incarcerated women in restrictive housing under subsection 7b71 which shall include the information described in paragraph 7#a74 7d7 ,notice ,not later than #bd hours after the confirmation of the pregnancy of an incarcerated woman by a health care professional1 that woman shall be notified1 orally and in writing1 by an appropriate health care professional1 correctional officer1 or ,united ,states ,marshal1 as applicable-- 7#a7 of the restrictions on the use of restrictive housing placements under this section2 7#b7 of the right of the incarcerated woman to make a confidential report of a violation of restrictions on the use of restrictive housing placement2 and 7#c7 that the facility staff have been advised of all rights of the incarcerated woman under subsection 7a74 7e7 ,violation reporting process ,not later than #ahj days after the date of enactment of the ,pregnant ,women in ,custody ,act1 the ,director of the ,bureau of ,prisons and the ,director of the ,united ,states ,marshals ,service shall establish processes through which an incarcerated person may report a violation of this section4 7f7 ,notification of rights ,the warden of the ,bureau of ,prisons facility where a pregnant woman is in custody shall notify necessary facility staff of the pregnancy and of the rights of the incarcerated pregnant woman under subsection 7a74 7g7 ,retaliation ,it shall be unlawful for any ,bureau of ,prisons or ,united ,states ,marshals ,service employee to retaliate against an incarcerated person for reporting under the processes established under subsection 7e7 a violation of subsection 7a74 7h7 ,education ,not later than #ij days after the date of enactment of the ,pregnant ,women in ,custody ,act1 the ,director of the ,bureau of ,prisons and the ,director of the ,united ,states ,marshals ,service shall each-- 7#a7 develop education guidelines regarding the physical and mental health needs of incarcerated pregnant women1 and the use of restrictive housing placements on incarcerated women during the period of pregnancy1 labor1 and postpartum recovery2 and 7#b7 incorporate such guidelines into appropriate education programs4 7i7 ,definition ,in this section1 the term restrictive housing means any type of detention that involves-- 7#a7 removal from the general inmate population1 whether voluntary or involuntary2 7#b7 placement in a locked room or cell1 whether alone or with another inmate2 and 7#c7 inability to leave the room or cell for the vast majority of the day4 4 7b7 ,clerical amendment ,the table of sections for chapter #cag of title #ah1 ,united ,states ,code1 is amended by striking the item relating to section #dcbb and inserting the following3 #dcbb4 ,use of restrictive housing on incarcerated women during the period of pregnancy1 labor1 and postpartum recovery prohibited4 4 #f4 ,treatment of women with high-risk pregnancies 7a7 ,in general ,chapter #cjc of title #ah1 ,united ,states ,code1 is amended by adding at the end the following3 #djeb4 ,treatment of incarcerated pregnant women 7a7 ,high-,risk pregnancy health care ,the ,director of the ,bureau of ,prisons shall ensure that each incarcerated pregnant woman receives an evaluation to determine if the pregnancy is high-risk and1 if so1 receives healthcare appropriate for a high-risk pregnancy1 including obstetrical and gynecological care1 during pregnancy and postpartum recovery4 7b7 ,high-,risk pregnancies 7#a7 ,in general ,the ,director of the ,bureau of ,prisons shall transfer to a ,residential ,reentry ,center with adequate health care during her pregnancy and postpartum recovery any incarcerated woman who-- 7,a7 is determined by a health care professional to have a high-risk pregnancy2 and 7,b7 agrees to be transferred4 7#b7 ,priority ,the ,residential ,reentry ,center to which an incarcerated pregnant woman is transferred under paragraph 7#a7 shall1 to the extent practicable1 be in a geographical location that is close to the family members of the incarcerated pregnant woman4 7#c7 ,transportation ,to transport an incarcerated pregnant woman to a ,residential ,reentry ,center1 the ,director of the ,bureau of ,prisons shall provide to the woman a mode of transportation that a healthcare professional has determined to be safe for transporting the pregnant woman4 7#d7 ,service of sentence ,any time accrued at a ,residential ,reentry ,center or alternative housing as a result of a transfer made under this section shall be credited toward service of the incarcerated pregnant woman's sentence4 7c7 ,definitions ,in this section3 7#a7 ,health care professional ,the term health care professional means-- 7,a7 a doctor of medicine or osteopathy who is authorized to diagnose and treat physical or mental health conditions under the laws of the ,state in which the doctor practices and where the facility is located2 7,b7 any physician's assistant or nurse practitioner who is supervised by a doctor of medicine or osteopathy described in subparagraph 7,a72 or 7,c7 any other person determined by the ,director of the ,bureau of ,prisons to be capable of providing health care services4 7#b7 ,high-risk pregnancy ,the term high-risk pregnancy means1 with respect to an incarcerated woman1 that the pregnancy threatens the health or life of the woman or pregnancy1 as determined by a health care professional4 7#c7 ,postpartum recovery ,the term postpartum recovery means the #c-month period beginning on the date on which an incarcerated pregnant woman gives birth1 or longer as determined by a health care professional following delivery1 and shall include the entire period that the incarcerated pregnant woman is in the hospital or infirmary4 7#d7 ,residential reentry center ,the term ,residential ,reentry ,center means a ,bureau of ,prisons contracted residential reentry center4 4 7b7 ,conforming amendment ,the table of sections for chapter #cjc of title #ah1 ,united ,states ,code1 is amended by adding at the end the following3 #djeb4 ,treatment of incarcerated pregnant women4 4 #g4 ,reporting requirement regarding claims filed by pregnant inmates ,the ,director of the ,federal ,bureau of ,prisons shall make publicly available on the website of the ,federal ,bureau of ,prisons on an annual basis the following information3 7#a7 ,the total number of ,administrative ,remedy appeals related to pregnant inmates that were filed during the previous year4 7#b7 ,the total number of institution-level ,requests for ,administrative ,remedy related to pregnant inmates that were filed during the previous year4 7#c7 ,the total number of informal requests for administrative remedy related to pregnant inmates that were filed during the previous year4 7#d7 ,the total number of requests or appeals related to pregnant inmates during the previous year that were not resolved before the inmate gave birth or that were mooted because the inmate's pregnancy ended4 7#e7 ,the average amount of time that each category of request or appeal took to resolve during the previous year4 7#f7 ,the shortest and longest amounts of time that a request or appeal in each category that was resolved in the last year took to resolve4 #h4 ,education and technical assistance ,the ,director of the ,national ,institute of ,corrections shall provide education and technical assistance1 in conjunction with the appropriate public agencies1 at ,state and local correctional facilities that house women and facilities in which incarcerated women go into labor and give birth1 in order to educate the employees of such facilities1 including health personnel1 on the dangers and potential mental health consequences associated with the use of restrictive housing and restraints on incarcerated women during pregnancy1 labor1 and postpartum recovery1 and on alternatives to the use of restraints and restrictive housing placement4 #i4 ,bureau of prisons staff and united states marshals training 7a7 ,bureau of prisons training 7#a7 ,in general 7,a7 ,initial training ,not later than #ahj days after the date of enactment of this ,act1 the ,director of the ,bureau of ,prisons shall provide training to carry out the requirements of this ,act and the amendments made by this ,act to each correctional officer at any ,bureau of ,prisons facility that houses women who is employed on the date of enactment of this ,act4 7,b7 ,subsequent training ,after the initial training provided under subparagraph 7,a71 the ,director of the ,bureau of ,prisons shall provide training to carry out the requirements of this ,act and the amendments made by this ,act twice each year to each correctional officer at any ,bureau of ,prisons facility that houses women4 7#b7 ,new hires 7,a7 ,definition ,in this paragraph1 the term covered new correctional officer means an individual appointed to a position as a correctional officer at a ,bureau of ,prisons facility that houses women on or after the date that is #ahj days after the date of enactment of this ,act4 7,b7 ,training ,the ,director of the ,bureau of ,prisons shall train each covered new correctional officer to carry out the requirements of this ,act and the amendments made by this ,act not later than #cj days after the date on which the covered new correctional officer is appointed4 7b7 ,united states marshals training 7#a7 ,in general ,on and after the date that is #ahj days after the date of enactment of this ,act1 the ,director of the ,united ,states ,marshals ,service shall ensure that each ,deputy ,united ,states ,marshal has received trained pursuant to the guidelines described in subsection 7c74 7#b7 ,new hires 7,a7 ,definition ,in this paragraph1 the term new ,deputy ,united ,states ,marshal means an individual appointed to a position as a ,deputy ,united ,states ,marshal after the date of enactment of this ,act4 7,b7 ,training ,not later than #cj days after the date on which a new ,deputy ,united ,states ,marshal is appointed1 the new ,deputy ,united ,states ,marshal shall receive training pursuant to the guidelines described in subsection 7c74 7c7 ,guidelines 7#a7 ,in general ,the ,director of the ,bureau of ,prisons and the ,united ,states ,marshals ,service shall each develop guidelines on the treatment of incarcerated women during pregnancy1 labor1 and postpartum recovery and incorporate such guidelines in the training required under this section4 7#b7 ,contents ,the guidelines developed under paragraph 7#a7 shall include guidance on-- 7,a7 the transportation of incarcerated pregnant women2 7,b7 housing of incarcerated pregnant women2 7,c7 nutritional requirements for incarcerated pregnant women2 and 7,d7 the right of a health care professional to request that restraints not be used4 #aj4 ,,gao study on ,state and local correctional facilities ,the ,comptroller ,general of the ,united ,states shall conduct a study of services and protections provided for pregnant incarcerated women in local and ,state correctional settings1 including-- 7#a7 policies on-- 7,a7 obstetrical and gynecological care2 7,b7 education on nutritional issues and health and safety risks associated with pregnancy2 7,c7 mental health and substance use treatment2 7,d7 access to prenatal and post-delivery support services and programs2 and 7,e7 the use of restraints and restrictive housing placement2 and 7#b7 the extent to which the intent of such policies is fulfilled4 #aa4 ,determination of budgetary effects ,the budgetary effects of this ,act1 for the purpose of complying with the ,statutory ,pay-,as-,you-,go ,act of #bjaj1 shall be determined by reference to the latest statement titled ,budgetary ,effects of ,,paygo ,legislation for this ,act1 submitted for printing in the ,congressional ,record by the ,chairman of the ,house ,budget ,committee1 provided that such statement has been submitted prior to the vote on passage4