Section 3999.427 - Hunger Strike(a) Incarcerated person who are participating in an individual or mass organized hunger strike shall be provided health care (including assessment, monitoring, and treatment) regardless of the reason for their strike.(b) The Warden or designee and Chief Executive Officer (health care) or designee shall determine when a mass organized hunger strike exists.(c) Response to hunger strikes.(1) Health care staff shall not prescribe meal replacements, including milk, juice, or nutritional supplements to patients participating in a hunger strike unless medically necessary.(2) Designated licensed health care staff shall observe all participants daily and determine any need for immediate medical attention.(3) When custody staff identifies an incarcerated person as a participant in a hunger strike, staff shall adhere to the following timelines:(A) Within 24 hours, health care staff shall notify each participant in a mass hunger strike that they are eligible for sick call evaluations during the hunger strike.(B) Within 72 hours, mental health staff shall conduct a mental health evaluation for patients in the Mental Health Services Delivery System (MHSDS) or Developmental Disability Program (DDP). After the initial 72-hour evaluation, patients in the MHSDS or DDP shall have a mental health evaluation scheduled at least every 14 calendar days.(C) Within seven calendar days, the participant shall be scheduled for a face-to-face triage assessment by a Registered Nurse who shall provide education on the adverse effects and risks of fasting and the refeeding syndrome.(D) After 14 calendar days, and at least weekly thereafter, health care staff shall schedule identified participant(s) (even if not in a high-risk group) for a Primary Care Provider visit which will include a Body Mass Index determination.(E) After 21 calendar days, participant(s) shall be provided with written information about advance directives including, but not limited to, the following forms; CDCR 7421, Advance Directive for Health Care, and CDCR 7465, Physician Orders for Life-Sustaining Treatment (POLST).(d) A hunger strike participant may not refuse placement or housing for medical needs.(e) Informed refusal. (1) The participant shall receive information about their medical condition, the proposed course of treatment (including nutrition support), and their prospects for recovery. If the participant refuses recommended medical care, the participant shall be asked to sign a CDCR 7225, Refusal of Examination and/or Treatment, and complete a POLST to delineate the care they will accept.(2) Health care staff shall grant participants autonomy in health care decisions. (A) If the participant refuses to indicate their wishes regarding medical management including questions of refeeding and resuscitation if required, then all necessary interventions including artificial nutrition to protect life and limb shall be carried out.(B) If the participant is deemed unable to give informed consent, the Department shall obtain a court order to treat the participant.(3) Health care staff shall not participate in forced feeding of patients.Cal. Code Regs. Tit. 15, § 3999.427
Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; Sections 3200- 3212, Probate Code; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.
Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code; Sections 3200- 3212, Probate Code; and Plata v. Newsom (No. C01-1351 JST), U.S. District Court, Northern District of California.
1. New section filed 7-1-2019 as an emergency; operative 7/1/2019 (Register 2019, No. 27). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 12-9-2019 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 12-5-2019 as an emergency; operative 12/10/2019 (Register 2019, No. 49). Pursuant to Penal Code section 5058.3, a Certificate of Compliance must be transmitted to OAL by 3-9-2020 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 3-9-2020 as an emergency; operative 3/10/2020 (Register 2020, No. 11). A Certificate of Compliance must be transmitted to OAL by 6-8-2020 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 3-9-2020 order transmitted to OAL 6-8-2020 and filed 7/20/2020 (Register 2020, No. 30).
5. Change without regulatory effect amending subsections (a) and (c)(3) filed 7-1-2024 pursuant to section 100, title 1, California Code of Regulations (Register 2024, No. 27).