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[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7718 Reported in House (RH)]

<DOC>

                                                 Union Calendar No. 436
116th CONGRESS
  2d Session
                                H. R. 7718

                          [Report No. 116-536]

To address the health needs of incarcerated women related to pregnancy 
                and childbirth, and for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             July 22, 2020

 Ms. Bass (for herself, Mr. Reschenthaler, Ms. Clark of Massachusetts, 
 and Mrs. Lesko) introduced the following bill; which was referred to 
                     the Committee on the Judiciary

                           September 24, 2020

 Additional sponsors: Mrs. Rodgers of Washington, Mrs. Watson Coleman, 
  Ms. Lee of California, Ms. Speier, Mrs. Walorski, Mr. Chabot, Mrs. 
   Wagner, Mrs. Lawrence, Mr. Carson of Indiana, Mr. Blumenauer, Ms. 
 Norton, Ms. Meng, Ms. Adams, Ms. Bonamici, Ms. Wasserman Schultz, Ms. 
Sewell of Alabama, Mrs. Bustos, Ms. Kaptur, Mrs. Beatty, Mr. Vela, Ms. 
  Roybal-Allard, Mr. Brown of Maryland, Mr. Hastings, Mrs. Hayes, Mr. 
 Thompson of Mississippi, Mr. Cardenas, Mr. Ryan, Ms. Blunt Rochester, 
    Mr. Correa, Ms. Jackson Lee, Mr. Cohen, and Ms. Garcia of Texas

                           September 24, 2020

    Reported from the Committee on the Judiciary; committed to the 
 Committee of the Whole House on the State of the Union and ordered to 
                               be printed

_______________________________________________________________________

                                 A BILL

 
To address the health needs of incarcerated women related to pregnancy 
                and childbirth, and for other purposes.

 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

     This Act may be cited as the ``Protecting the Health and Wellness 
of Babies and Pregnant Women in Custody Act''.

SEC. 2. DATA COLLECTION.

    (a) In General.--Beginning not later than 1 year after the date of 
the enactment of this Act, pursuant to the authority under section 302 
of the Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C. 
10132), 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 Federal, State, tribal, and local 
levels, including--
            (1) demographic and other information about incarcerated 
        women who are pregnant, in labor, or in postpartum recovery, 
        including the race, ethnicity, and age of the pregnant woman;
            (2) the provision of pregnancy care and services provided 
        for such women, including--
                    (A) whether prenatal, delivery, and post-delivery 
                check-up visits were scheduled and provided;
                    (B) whether a social worker, psychologist, doula or 
                other support person, or pregnancy or parenting program 
                was offered and provided during pregnancy and delivery;
                    (C) 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 provided;
                    (D) the number of days the mother stayed in the 
                hospital post-delivery;
                    (E) the number of days the infant remained with the 
                mother post-delivery; and
                    (F) the number of days the infant remained in the 
                hospital after the mother was discharged;
            (3) the location of the nearest hospital with a licensed 
        obstetrician-gynecologist in proximity to where the inmate is 
        housed and the length of travel required to transport the 
        inmate;
            (4) whether a written policy or protocol is in place to 
        respond to unexpected childbirth, labor, deliveries, and 
        medical complications related to the pregnancies of 
        incarcerated pregnant women and for incarcerated pregnant women 
        experiencing labor or medical complications related to 
        pregnancy outside of a hospital;
            (5) the number of incarcerated women who are determined by 
        a health care professional to have a high-risk pregnancy;
            (6) the total number of incarcerated pregnant women and the 
        number of incarcerated women who became pregnant while 
        incarcerated;
            (7) the number of incidents in which an incarcerated woman 
        who is pregnant, in labor, or in postpartum recovery is placed 
        in restrictive housing, the reason for such restriction or 
        placement, and the circumstances under which each incident 
        occurred, including the duration of time in restrictive 
        housing, during--
                    (A) pregnancy;
                    (B) labor;
                    (C) delivery;
                    (D) postpartum recovery; and
                    (E) the 6-month period after delivery; and
            (8) the disposition of the custody of the infant post-
        delivery.
    (b) Personally Identifiable Information.--Data collected under this 
paragraph may not contain any personally identifiable information of 
any incarcerated pregnant woman.

SEC. 3. CARE FOR FEDERALLY INCARCERATED WOMEN RELATED TO PREGNANCY AND 
              CHILDBIRTH.

    (a) In General.--The Director of the Bureau of Prisons shall ensure 
that appropriate services and programs are provided to women in 
custody, to address the health and safety needs of such women related 
to pregnancy and childbirth. 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 facility.
    (b) Services and Programs Provided.--The Director of the Bureau of 
Prisons shall ensure that the following services and programs are 
available to women in custody:
            (1) Access to complete appropriate health services for the 
        life cycle of women.--The Director of the Bureau of Prisons 
        shall provide to each woman in custody who is of reproductive 
        age pregnancy testing, contraception, and testing for sexually 
        transmitted diseases and provide each woman with the option to 
        decline such services.
            (2) Compliance with protocols relating to health of a 
        pregnant woman.--On confirmation of the pregnancy of a woman in 
        custody by clinical diagnostics and assessment, the chief 
        health care professional of a Bureau of Prisons facility that 
        houses women shall ensure that a summary of all appropriate 
        protocols directly pertaining to the safety and well-being of 
        the woman are provided to the woman and that such protocols are 
        complied with, including an assessment of undue safety risks 
        and necessary changes to accommodate the woman where and when 
        appropriate, as it relates to--
                    (A) housing or transfer to a lower bunk for safety 
                reasons;
                    (B) appropriate bedding or clothing to respond to a 
                woman's changing physical requirements and the 
                temperature in housing units;
                    (C) regular access to water and bathrooms;
                    (D) a diet that 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 301 of the National Nutrition 
                Monitoring and Related Research Act of 1990 (7 U.S.C. 
                5341(a)(3)), and that includes--
                            (i) any appropriate dietary supplement, 
                        including prenatal vitamins;
                            (ii) timely and regular nutritious meals;
                            (iii) additional caloric content in meals 
                        provided;
                            (iv) a prohibition on withholding food from 
                        an incarcerated pregnant woman or serving any 
                        food that is used as a punishment, including 
                        nutraloaf or any food similar to nutraloaf that 
                        is not considered a nutritious meal; and
                            (v) 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 provide;
                    (E) modified recreation and transportation, in 
                accordance with standards within the obstetrical and 
                gynecological care community, to prevent overexertion 
                or prolonged periods of inactivity; and
                    (F) 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 provide.
            (3) Education and support services.--
                    (A) Pregnancy in custody.--In the case of a woman 
                who is pregnant at intake or who becomes pregnant while 
                in custody, that woman shall, at intake or not later 
                than 48 hours after pregnancy is confirmed, as 
                appropriate, receive prenatal education, counseling, 
                and birth support services provided by a provider 
                trained to provide such services, including--
                            (i) information about the parental rights 
                        of the woman, including the right to place the 
                        child in kinship care, and notice of the rights 
                        of the child;
                            (ii) information about family preservation 
                        support services that are available to the 
                        woman;
                            (iii) information about the nutritional 
                        standards referred to in paragraph (2)(D);
                            (iv) information pertaining to the health 
                        and safety risks of pregnancy, childbirth, and 
                        parenting, including postpartum depression;
                            (v) information on breastfeeding, 
                        lactation, and breast health;
                            (vi) appropriate educational materials, 
                        resources, and services related to pregnancy, 
                        childbirth, and parenting;
                            (vii) information and notification services 
                        for incarcerated parents regarding the risk of 
                        debt repayment obligations associated with 
                        their child's participation in social welfare 
                        programs, including assistance under any State 
                        program funded under part A of title IV of the 
                        Social Security Act (42 U.S.C. 601 et seq.) or 
                        benefits under the supplemental nutrition 
                        assistance program, as defined in section 3 of 
                        the Food and Nutrition Act of 2008 (7 U.S.C. 
                        2012), or any State program carried out under 
                        that Act; and
                            (viii) information from the Office of Child 
                        Support Enforcement of the Department of Health 
                        and Human Services regarding seeking or 
                        modifying child support while incarcerated, 
                        including how to participate in the Bureau of 
                        Prison's Inmate Financial Responsibility 
                        Program under subpart B of title 28, Code of 
                        Federal Regulations (or any successor program).
                    (B) Birth while in custody or prior to custody.--In 
                the case of a woman who gave birth in custody or who 
                experienced any other pregnancy outcome during the 6-
                month period immediately preceding intake, that woman 
                shall receive counseling provided by a licensed or 
                certified provider trained to provide such services, 
                including--
                            (i) information about the parental rights 
                        of the woman, including the right to place the 
                        child in kinship care, and notice of the rights 
                        of the child; and
                            (ii) information about family preservation 
                        support services that are available to the 
                        woman.
            (4) Testing.--Not later than 1 day after an incarcerated 
        woman notifies an employee of the Bureau of Prisons that the 
        woman may be pregnant, a Bureau of Prisons healthcare care 
        professional shall administer a pregnancy test to determine 
        whether the woman is pregnant.
            (5) Evaluations.--Each woman in custody who is pregnant or 
        whose pregnancy results in a birth or any other pregnancy 
        outcome during the 6-month period immediately preceding intake 
        or any time in custody thereafter shall be evaluated not later 
        than 4 days after intake or confirmation of pregnancy through 
        evidence-based screening and assessment for substance use 
        disorders or mental health conditions, including postpartum 
        depression or depression related to a pregnancy outcome or 
        early child care. Screening shall include identification of any 
        of the following risk factors:
                    (A) An existing mental or physical health condition 
                or substance use disorder.
                    (B) Being underweight or overweight.
                    (C) Multiple births or a previous still birth.
                    (D) A history of preeclampsia.
                    (E) A previous Caesarean section.
                    (F) A previous miscarriage.
                    (G) Being older than 35 or younger than 15.
                    (H) Being diagnosed with the human immunodeficiency 
                virus, hepatitis, diabetes, or hypertension.
                    (I) Such other risk factors as the chief health 
                care professional of a Bureau of Prisons facility that 
                houses women may determine to be appropriate.
            (6) Unexpected births rulemaking.--Not later than 180 days 
        after the date of enactment of this Act, the Attorney General 
        shall make rules establishing procedures for responding to 
        unexpected childbirth deliveries, labor complications, and 
        medical complications related to pregnancy if a woman in 
        custody is unable to access a hospital in a timely manner.
            (7) Treatment.--In the case of any woman in custody who, 
        after an evaluation under paragraph (4), is diagnosed as having 
        a substance use disorder or a mental health disorder, that 
        woman shall be entitled to treatment in accordance with the 
        following:
                    (A) Treatment shall include participation in a 
                support group, including a 12-step program, such as 
                Alcoholics Anonymous, Narcotics Anonymous, and Cocaine 
                Anonymous or a comparable nonreligious program.
                    (B) Treatment may include psychosocial 
                interventions and medication.
                    (C) In the case that adequate treatment cannot be 
                provided to a woman in custody in a Bureau of Prisons 
                facility, the Director of the Bureau of Prisons shall 
                transfer the woman to a residential reentry program 
                that offers such treatment pursuant to section 508 of 
                the Public Health Service Act (42 U.S.C. 290bb-1).
                    (D) To the extent practicable, treatment for 
                substance use disorders provided pursuant to this 
                section shall be conducted in a licensed hospital.

SEC. 4. USE OF RESTRICTIVE HOUSING AND RESTRAINTS ON INCARCERATED 
              PREGNANT WOMEN DURING PREGNANCY, LABOR, AND POSTPARTUM 
              RECOVERY PROHIBITED.

    (a) In General.--Section 4322 of title 18, United States Code, is 
amended to read as follows:
``Sec. 4322. Use of restraints and restrictive housing on incarcerated 
              women during the period of pregnancy, labor, and 
              postpartum recovery prohibited and to improve pregnancy 
              care for women in Federal prisons
    ``(a) Prohibition.--Except as provided in subsection (b), beginning 
on the date on which pregnancy is confirmed by a health care 
professional and ending not earlier than 12 weeks after delivery, an 
incarcerated woman in the custody of the Bureau of Prisons, or in the 
custody of the United States Marshals Service pursuant to section 4086, 
shall not be placed in restraints or held in restrictive housing.
    ``(b) Exceptions.--
            ``(1) Use of restraints.--The prohibition under subsection 
        (a) shall not apply if the senior Bureau of Prisons official or 
        United States Marshals Service official overseeing women's 
        health and services and a health care professional responsible 
        for the health and safety of the incarcerated woman determines 
        that the use of restraints is appropriate for the medical 
        safety of the woman, and the health care professional reviews 
        such determination not later than every 6 hours after such use 
        is initially approved until such use is terminated.
            ``(2) Situational use.--The individualized determination 
        described under paragraph (1) shall only apply to a specific 
        situation and must be reaffirmed through the same process to 
        use restraints again in any future situation involving the same 
        woman.
            ``(3) Access to care.--Immediately upon the cessation of 
        the use of restraints or restrictive housing as outlined in 
        this subsection, the Director of the Bureau of Prisons or the 
        United States Marshal Service shall provide the incarcerated 
        woman with immediate access to physical and mental health 
        assessments and all recommended treatment.
            ``(4) Response to behavioral risks in the bureau of 
        prisons.--
                    ``(A) Restrictive housing.--The prohibition under 
                subsection (a) 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 services, in consultation with senior 
                officials in health services, makes an individualized 
                determination that restrictive housing is required as a 
                temporary response to behavior that poses a serious and 
                immediate risk of physical harm.
                    ``(B) Review.--The official who makes a 
                determination under subparagraph (A) shall review such 
                determination every 4 hours for the purpose of removing 
                an incarcerated woman as quickly as feasible from 
                restrictive housing.
                    ``(C) Restrictive housing plan.--The official who 
                makes a determination under subparagraph (A) shall 
                develop an individualized plan to move an incarcerated 
                woman to less restrictive housing within a reasonable 
                amount of time, not to exceed 2 days.
                    ``(D) Monitoring.--An incarcerated woman who is 
                placed in restrictive housing pursuant to this 
                paragraph shall be--
                            ``(i) monitored every hour;
                            ``(ii) placed in a location visible to 
                        correctional officers; and
                            ``(iii) prohibited from being placed in 
                        solitary confinement if the incarcerated woman 
                        is in her third trimester.
    ``(c) Reports.--
            ``(1) Report to the director and health care professional 
        after the use of restraints.--If an official identified in 
        subsection (b)(1) or a correctional officer uses restraints on 
        an incarcerated woman under subsection (b), that official (or 
        an officer or marshal designated by that official) or 
        correctional officer shall submit, not later than 30 days after 
        placing the woman in restraints, to the Director of the Bureau 
        of Prisons or the Director of the U.S. Marshal Service, as 
        applicable, a written report which describes the facts and 
        circumstances surrounding the use of restraints, and includes 
        each of the following:
                    ``(A) A description of all attempts to use 
                alternative interventions and sanctions before the 
                restraints were used.
                    ``(B) A description of the circumstances that led 
                to the use of restraints.
                    ``(C) Strategies the facility is putting in place 
                to identify more appropriate alternative interventions 
                should a similar situation arise again.
            ``(2) Report to congress.--Beginning on the date that is 6 
        months after the date of enactment of the Protecting the Health 
        and Wellness of Babies and Pregnant Women in Custody Act, and 
        every 6 months thereafter for a period of 10 years, the 
        Attorney General shall submit to the Committees on the 
        Judiciary of the House of Representatives and the Senate a 
        report on--
                    ``(A) the reasoning upon which the determination to 
                use restraints was made;
                    ``(B) the details of the use of restraints, 
                including the type of restraints used and length of 
                time during which restraints were used; and
                    ``(C) any resulting physical effects on the 
                prisoner observed by or known to the corrections 
                official or United States Marshal, as applicable.
            ``(3) Report to the director and health care professional 
        after placement in restrictive housing.--If an official 
        identified in subsection (b)(3), correctional officer, or 
        United States Marshal places or causes an incarcerated woman to 
        be placed in restrictive housing under such subsection, that 
        official, correctional officer, or United States Marshal shall 
        submit, not later than 30 days after placing or causing the 
        placement of the incarcerated woman in restrictive housing, to 
        the Director of the Bureau of Prisons or the Director of the 
        United States Marshals Service, as applicable, and to the 
        health care professional responsible for the health and safety 
        of the woman, a written report which describes the facts and 
        circumstances surrounding the restrictive housing placement, 
        and includes the following:
                    ``(A) The reasoning upon which the determination 
                for the placement was made.
                    ``(B) The details of the placement, 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 placement.
                    ``(C) A description of all attempts to use 
                alternative interventions and sanctions before the 
                restrictive housing was used.
                    ``(D) Any resulting physical effects on the woman 
                observed by or reported by the health care professional 
                responsible for the health and safety of the woman.
                    ``(E) Strategies the facility is putting in place 
                to identify more appropriate alternative interventions 
                should a similar situation arise again.
            ``(4) Report to congress.--Beginning on the date that is 6 
        months after the date of enactment of the Protecting the Health 
        and Wellness of Babies and Pregnant Women in Custody Act, and 
        every 6 months thereafter for a period of 10 years, the 
        Attorney General shall submit to the Committees on the 
        Judiciary of the House of Representatives and the Senate a 
        report on the information described in paragraph (3).
    ``(d) Notice.--Not later than 24 hours after the confirmation of an 
incarcerated woman's pregnancy by a health care professional, that 
woman shall be notified, orally and in writing, by an appropriate 
health care professional, correctional officer, or United States 
Marshal, as applicable--
            ``(1) of the restrictions on the use of restraints and 
        restrictive housing placements under this section;
            ``(2) of the incarcerated woman's right to make a 
        confidential report of a violation of restrictions on the use 
        of restraints or restrictive housing placement; and
            ``(3) that the facility staff have been advised of all 
        rights of the incarcerated woman under subsection (a).
    ``(e) Violation Reporting Process.--Not later than 180 days after 
the date of enactment of this Act, 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 section.
    ``(f) 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 incarcerated pregnant 
woman's rights under subsection (a).
    ``(g) Retaliation.--It shall be unlawful for any Bureau of Prisons 
or United States Marshal Service employee to retaliate against an 
incarcerated person for reporting under the provisions of subsection 
(e) a violation of subsection (a).
    ``(h) Education.--Not later than 90 days after the date of 
enactment of the Protecting the Health and Wellness of Babies and 
Pregnant Women in Custody Act, the Director of the Bureau of Prisons 
and the Director of the United States Marshals Service shall each 
develop education guidelines regarding the physical and mental health 
needs of incarcerated pregnant women, and the use of restraints and 
restrictive housing placements on incarcerated women during the period 
of pregnancy, labor, and postpartum recovery, and shall incorporate 
such guidelines into appropriate education programs.
    ``(i) Definition.--In this section:
            ``(1) Restraints.--The term `restraints' means any physical 
        or mechanical device used to control the movement of an 
        incarcerated pregnant woman's body, limbs, or both.
            ``(2) Restrictive housing.--The term `restrictive housing' 
        means any type of detention that involves--
                    ``(A) removal from the general inmate population, 
                whether voluntary or involuntary;
                    ``(B) placement in a locked room or cell, whether 
                alone or with another inmate; and
                    ``(C) inability to leave the room or cell for the 
                vast majority of the day.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 317 of title 18, United States Code, is amended by amending the 
item relating to section 4322 to read as follows:

``4322. Use of restraints and restrictive housing on incarcerated women 
                            during the period of pregnancy, labor, and 
                            postpartum recovery prohibited and to 
                            improve pregnancy care for women in Federal 
                            prisons.''.

SEC. 5. TREATMENT OF WOMEN WITH HIGH-RISK PREGNANCIES.

    (a) In General.--Chapter 303 of title 18, United States Code, is 
amended by adding at the end the following:
``Sec. 4051. Treatment of incarcerated pregnant women
    ``(a) High-Risk Pregnancy Health Care.--The Director of the Bureau 
of Prisons shall ensure that each incarcerated pregnant woman receives 
health care appropriate for a high-risk pregnancy, including 
obstetrical and gynecological care, during pregnancy and post-partum 
recovery.
    ``(b) High-Risk Pregnancies.--
            ``(1) In general.--The Director of the Bureau of Prisons 
        shall transfer any incarcerated woman, who is determined by a 
        health care professional to have a high-risk pregnancy and who 
        agrees to be transferred, to a Residential Reentry Center with 
        adequate health care during her pregnancy and post-partum 
        recovery.
            ``(2) Priority.--The Residential Reentry Center to which an 
        incarcerated pregnant woman is transferred pursuant to 
        paragraph (1) shall be in a geographical location that is close 
        to the family members of the incarcerated pregnant woman. In 
        the case that a Residential Reentry Center is unavailable, the 
        incarcerated pregnant woman shall be transferred to alternative 
        housing, including housing with a family member.
            ``(3) Transportation.--To transport an incarcerated 
        pregnant woman to a Residential Reentry Center, the Director of 
        the Bureau of Prisons shall provide to the woman a mode of 
        transportation that has been approved by the woman's health 
        care professional, at no expense to the woman.
            ``(4) Monitoring.--In the case that an incarcerated 
        pregnant woman transferred to alternative housing pursuant to 
        this section is monitored electronically, an ankle monitor may 
        not be used on the woman, unless there is no feasible 
        alternative for monitoring the woman.
            ``(5) Service of sentence.--Any time accrued at a 
        Residential Reentry Center or alternative housing as a result 
        of a transfer made pursuant to this section shall be credited 
        toward service of the incarcerated pregnant woman's sentence.
            ``(6) Credit for pretrial custody.--In the case of an 
        incarcerated pregnant woman, any time accrued in pretrial 
        custody shall be credited toward service of the woman's 
        sentence.
    ``(c) Definitions.--In this section:
            ``(1) Family member.--The term `family member' means any 
        individual related by blood or affinity whose close association 
        with the incarcerated pregnant woman is the equivalent of a 
        family relationship, including a parent, sibling, child, or 
        individual standing in loco parentis.
            ``(2) Residential reentry center.--The term `Residential 
        Reentry Center' means a Bureau of Prisons contracted 
        residential reentry center.
            ``(3) Health care professional.--
                    ``(A) In general.--The term `health care 
                professional' means--
                            ``(i) a doctor of medicine or osteopathy 
                        who is authorized to practice medicine or 
                        surgery by the State in which the doctor 
                        practices;
                            ``(ii) any physician's assistant or nurse 
                        practitioner who is supervised by a doctor of 
                        medicine or osteopathy described in clause (i); 
                        or
                            ``(iii) any other person determined by the 
                        Secretary to be capable of providing health 
                        care services.
                    ``(B) Other health care services.--A person is 
                capable of providing health care services if the person 
                is--
                            ``(i) a podiatrist, dentist, clinical 
                        psychologist, optometrist, or chiropractor 
                        (limited to treatment consisting of manual 
                        manipulation of the spine to correct a 
                        subluxation as demonstrated by X-ray to exist) 
                        authorized to practice in the State and 
                        performing within the scope of their practice 
                        as defined under State law;
                            ``(ii) a nurse practitioner, nurse-midwife, 
                        clinical social worker, or physician's 
                        assistant who is authorized to practice under 
                        State law and who is performing within the 
                        scope of their practice as defined under State 
                        law; and
                            ``(iii) any health care professional from 
                        whom an employer or the employer's group health 
                        plan's benefits manager will accept 
                        certification of the existence of a serious 
                        health condition to substantiate a claim for 
                        benefits.
                    ``(C) Authorized to practice in the state.--The 
                term `authorized to practice in the State' means that a 
                professional must be authorized to diagnose and treat 
                physical or mental health conditions under the laws of 
                the State in which the professional practices and where 
                the facility is located.
            ``(4) High-risk pregnancy.--The term `high-risk pregnancy' 
        means, with respect to an incarcerated woman, that the 
        pregnancy threatens the health or life of the woman or 
        pregnancy, as determined by a health care professional.
            ``(5) Post-partum recovery.--The term `post-partum 
        recovery' means the 3-month period beginning on the date on 
        which an incarcerated pregnant woman gives birth.''.
    (b) Conforming Amendment.--The table of sections for chapter 303 of 
title 18, United States Code, is amended by adding at the end the 
following:

``4051. Treatment of incarcerated pregnant women.''.

SEC. 6. EXEMPTION OF INCARCERATED PREGNANT WOMEN FROM THE REQUIREMENTS 
              FOR SUITS BY PRISONERS.

    Section 7 of the Civil Rights of Institutionalized Persons Act (42 
U.S.C. 1997e) is amended--
            (1) in subsection (a), by inserting after the period at the 
        end the following: ``This subsection shall not apply with 
        respect to an incarcerated pregnant woman who brings an action 
        relating to or affecting the woman's pregnancy.''; and
            (2) in subsection (d)(1), insert ``, except an incarcerated 
        pregnant woman,'' before ``who is confined''.

SEC. 7. DEFINITIONS.

    In this Act:
            (1) In custody.--The term ``in custody'' means, with 
        respect to an individual, that the individual is under the 
        supervision of a Federal, State, tribal or local correctional 
        facility, including pretrial and contract facilities, and 
        juvenile or medical or mental health facilities.
            (2) Other pregnancy outcome.--The term ``other pregnancy 
        outcome'' means a pregnancy that ends in stillbirth, 
        miscarriage, or ectopic pregnancy.
            (3) Postpartum recovery.--The term ``postpartum recovery'' 
        means the 12-week period, or longer as determined by the health 
        care professional responsible for the health and safety of the 
        incarcerated pregnant woman, following delivery, and shall 
        include the entire period that the incarcerated pregnant woman 
        is in the hospital or infirmary.
            (4) Restraints.--The term ``restraints'' means any physical 
        or mechanical device used to control the movement of an 
        incarcerated pregnant woman's body, limbs, or both.
            (5) Restrictive housing.--The term ``restrictive housing'' 
        means any type of detention that involves--
                    (A) removal from the general inmate population, 
                whether voluntary or involuntary;
                    (B) placement in a locked room or cell, whether 
                alone or with another inmate; and
                    (C) inability to leave the room or cell for the 
                vast majority of the day.

SEC. 8. EDUCATION AND TECHNICAL ASSISTANCE.

    The Director of the National Institute of Corrections shall provide 
education and technical assistance, in conjunction with the appropriate 
public agencies, at State and local correctional facilities that house 
women and facilities in which incarcerated women go into labor and give 
birth, in order to educate the employees of such facilities, including 
health personnel, on the dangers and potential mental health 
consequences associated with the use of restrictive housing and 
restraints on incarcerated women during pregnancy, labor, and 
postpartum recovery, and on alternatives to the use of restraints and 
restrictive housing placement.

SEC. 9. BUREAU OF PRISONS STAFF AND U.S. MARSHALS TRAINING.

    (a) Bureau of Prisons Training.--Beginning not later than 180 days 
after the date of enactment of this Act, and biannually thereafter, the 
Director of the Bureau of Prisons shall train each correctional officer 
at any Bureau of Prisons women's facility to carry out the requirements 
of this Act.
    (b) New Hires.--Beginning not later than 180 days after the date of 
enactment of this Act, the Director of the Bureau of Prisons shall 
train any newly hired correctional officer at a Bureau of Prisons 
facility that houses women to carry out the requirements of this Act 
not later than 30 days after the date on which the officer is hired.
    (c) U.S. Marshal Training.--Beginning not later than 180 days after 
the date of enactment of this Act, and biannually thereafter, the 
Director of the U.S. Marshals Service shall ensure that each Deputy 
U.S. Marshal is trained pursuant to the guidelines described in 
subsection (d). Newly hired deputies shall receive such training not 
later than 30 days after the date on which such deputy starts 
employment.
    (d) Guidelines.--The Director of the Bureau of Prisons and the 
United States Marshals Service shall each develop guidelines on the 
treatment of incarcerated women during pregnancy, labor, and postpartum 
recovery and incorporate such guidelines in the training required under 
this section. Such guidelines shall include guidance on--
            (1) the transportation of incarcerated pregnant women;
            (2) housing of incarcerated pregnant women;
            (3) nutritional requirements for incarcerated pregnant 
        women; and
            (4) the right of a health care professional to request that 
        restraints not be used.

SEC. 10. 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 settings, including policies on 
obstetrical and gynecological care, education on nutrition, health and 
safety risks associated with pregnancy, mental health and substance use 
treatment, access to prenatal and post-delivery support services and 
programs, the use of restraints and restrictive housing placement, and 
the extent to which the intent of such policies are fulfilled.

SEC. 11. GAO STUDY ON FEDERAL PRETRIAL DETENTION FACILITIES.

    (a) Study.--The Comptroller General of the United States shall 
conduct a study of services and protections provided for pregnant women 
who are incarcerated in Federal pretrial detention facilities. 
Specifically, the study shall examine--
            (1) what available data indicate about pregnant women 
        detained or held in Federal pretrial detention facilities;
            (2) existing U.S. Marshals Service policies and standards 
        that address the care of pregnant women in Federal pretrial 
        detention facilities; and
            (3) what is known about the care provided to pregnant women 
        in Federal pretrial detention facilities.
    (b) Report and Best Practices.--Not later than 2 years after the 
date of enactment of this Act, the Comptroller General shall submit a 
report of the results of the study conducted under subsection (a) to 
the Committee on the Judiciary of the Senate and the Committee on the 
Judiciary of the House of Representatives. The report shall identify 
best practices for ensuring that Federal pretrial detention facilities 
implement services and protections for pregnant women consistent with 
this Act and shall provide recommendations on how to implement these 
best practices among all Federal pretrial detention facilities.
    (c) Definition.--For purposes of this section, the term ``Federal 
pretrial detention facilities'' includes State, local, private, or 
other facilities under contract with the U.S. Marshals Service for the 
purpose of housing Federal pretrial detainees.

SEC. 12. PWIC GRANT PROGRAM.

    Section 508 of the Omnibus Crime Control and Safe Streets Act of 
1968 (34 U.S.C. 10151 et seq.) is amended to read as follows:

``SEC. 508. PREGNANT WOMEN IN CUSTODY GRANT PROGRAM.

    ``(a) Short Title.--This section may be cited as the `Pregnant 
Women in Custody Grant Program of 2020' or the `PWIC Act of 2020'.
    ``(b) Establishment.--The Attorney General may make grants to 
eligible entities that have established a program to promote the health 
needs of incarcerated pregnant women in the criminal justice system at 
the State, tribal, and local levels or have declared their intent to 
establish such a program. Eligible entities shall--
            ``(1) promote the safety and wellness of pregnant women in 
        custody;
            ``(2) provide services for obstetrical and gynecological 
        care, for women in custody;
            ``(3) facilitate resources and support services for 
        nutrition and physical and mental health, for women in custody;
            ``(4) establish and maintain policies that are 
        substantially similar to the limitations imposed under section 
        4322 of title 18, United States Code, limiting the use of 
        restraints on pregnant women in custody; and
            ``(5) maintain, establish, or build post-delivery lactation 
        and nursery care or residential programs to keep the infant 
        with the mother and to promote and facilitate bonding skills 
        for incarcerated pregnant women and women with dependent 
        children.
    ``(c) Grant Period.--A grant awarded under this section shall be 
for a period of not more than 5 years.
    ``(d) Eligible Entity.--An entity is eligible for a grant under 
this section if the entity is--
            ``(1) a State or territory department of corrections;
            ``(2) a tribal entity that operates a correctional 
        facility; or
            ``(3) a unit of local government that operates a prison or 
        jail that houses women; or
            ``(4) a locally-based nonprofit organization, that has 
        partnered with a State or unit of local government that 
        operates a correctional facility, with expertise in providing 
        health services to incarcerated pregnant women.
    ``(e) Application.--To receive a grant under this section, an 
eligible entity shall submit an application to the Attorney General at 
such time, in such manner, and containing such information as the 
Attorney General may require, including a detailed description of the 
need for the grant and an account of the number of individuals the 
grantee expects to benefit from the grant.
    ``(f) Administrative Costs.--Not more than 5 percent of a grant 
awarded under this section may be used for costs incurred to administer 
such grant.
    ``(g) Construction Costs.--Notwithstanding any other provision of 
this Act, no funds provided under this section may be used, directly or 
indirectly, for construction projects, other than new construction or 
upgrade to a facility used to provide lactation, nursery, obstetrical, 
or gynecological services.
    ``(h) Priority Funding for States That Provide Programs and 
Services for Incarcerated Women Related to Pregnancy and Childbirth.--
In determining the amount provided to a State or unit of local 
government under this section, the Attorney General shall give priority 
to States or units of local government that have enacted laws or 
policies and implemented services or pilot programs for incarcerated 
pregnant women aimed at enhancing the safety and wellness of pregnant 
women in custody, including providing services for obstetrical and 
gynecological care, resources and support services for nutrition and 
physical and mental health, and post-delivery lactation and nursery 
care or residential programs to keep the infant with the mother and to 
promote and facilitate bonding skills for incarcerated pregnant women 
and women with dependent children.
    ``(i) Subgrant Priority.--A State that receives a grant under this 
section shall prioritize subgrants to a unit of local government within 
the State that has established a pilot program that enhances safety and 
wellness of pregnant women in custody.
    ``(j) Federal Share.--
            ``(1) In general.--The Federal share of a grant under this 
        section may not exceed 75 percent of the total costs of the 
        projects described in the grant application.
            ``(2) Waiver.--The requirement of paragraph (1) may be 
        waived by the Assistant Attorney General upon a determination 
        that the financial circumstances affecting the applicant 
        warrant a finding that such a waiver is equitable.
    ``(k) Compliance and Redirection of Funds.--
            ``(1) In general.--Not later than 1 year after an eligible 
        entity receives a grant under this section, such entity shall 
        implement a policy that is substantially similar to the policy 
        under section 3 of Protecting the Health and Wellness of Babies 
        and Pregnant Women in Custody Act.
            ``(2) Extension.--The Attorney General may provide a 120-
        day extension to an eligible entity that is making good faith 
        efforts to collect the information required under paragraph 
        (1).
    ``(l) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section, to remain available until 
expended--
            ``(1) for fiscal year 2021, $5,000,000;
            ``(2) for fiscal year 2022, $5,000,000;
            ``(3) for fiscal year 2023, $5,000,000;
            ``(4) for fiscal year 2024, $6,000,000; and
            ``(5) for fiscal year 2025, $6,000,000.
    ``(m) Funds To Be Supplemental.--To receive a grant under this 
section, the eligible entity shall certify to the Attorney General that 
the amounts received under the grant shall be used to supplement, not 
supplant, non-Federal funds that would otherwise be available for 
programs or services in the prison where funds will be used.
    ``(n) Unobligated and Unspent Funds.--Funds made available pursuant 
to this section that remain unobligated for a period of 6 months after 
the end of the fiscal year for which the funds have been appropriated 
shall be awarded to other recipients of this grant.
    ``(o) Civil Rights Obligation.--A recipient of a grant under this 
section shall be subject to the nondiscrimination requirement under 
section 40002(b)(13) of the Violence Against Women Act of 1994 (34 
U.S.C. 12291(b)(13)).
    ``(p) Definitions.--In this section, the term `in custody' means, 
with respect to an individual, that the individual is under the 
supervision of a Federal, State, tribal, or local correctional 
facility, including pretrial and contract facilities, and juvenile or 
medical or mental health facilities.''.

SEC. 13. PLACEMENT IN PRERELEASE CUSTODY.

    Section 3624(c)(1) of title 18, United States Code, is amended by 
adding at the end the following: ``Notwithstanding any other provision 
of this paragraph, in the case of a pregnant woman in custody, if that 
woman's due date is within the final year of her term of imprisonment, 
that woman may be placed into prerelease custody beginning not earlier 
than the date that is 2 months prior to that woman's due date.''.
                                                 Union Calendar No. 436

116th CONGRESS

  2d Session

                               H. R. 7718

                          [Report No. 116-536]

_______________________________________________________________________

                                 A BILL

To address the health needs of incarcerated women related to pregnancy 
                and childbirth, and for other purposes.

_______________________________________________________________________

                           September 24, 2020

Committed to the Committee of the Whole House on the State of the Union 
                       and ordered to be printed
```