Committee on Women and Gender Equity

Good morning and welcome to the New York City Council hearing, joint hearing for the Committee on Women and Gender Equity and the Committee on Criminal Justice. At this time, I'm going to ask that everyone in the room silence all cell phones and electronic devices. If you wish to testify, you need to fill out an appearance card. If you haven't done so but want to testify, see the sergeant-at-arms at the desk right outside and we'll get you signed up.

Most importantly, at this time, no one is allowed to approach the dais. Chair, you may begin.

Good morning, everyone. I'm Councilmember Amanza Farias, Chair of the Committee on Women and Gender Equity. I'm excited to be joined by Chair of the Committee on Criminal Justice, Councilmember Sylvina Brooks-Powers, for today's hearing on maternal health and criminal justice. First, I'd like to acknowledge my colleagues who are present, including Councilmembers Moreno and Caban. Thank you both for being here today.

The intersection of maternal health and the criminal justice system represents a critical public health and human rights crisis in the United States, where women are the fastest-growing segment of the incarcerated population. National data shows that among incarcerated women, 3 out of 4 are of childbearing age. Incarcerated pregnant individuals face severe systemic barriers, including inconsistent prenatal care, high rates of untreated substance use, and mental health conditions and the use of shackling during labor and delivery.

Whether an incarcerated pregnant person decides to carry their pregnancy to term or have an abortion, they have a constitutionally protected right to obtain appropriate medical care. It's important to note that mass incarceration and the maternal mortality crisis disproportionately impact Black and low-income women. Communities of color are disproportionately represented in New York City jail admissions, Making up almost 90% of admissions, despite only compromising 52% of the city's general population.

When compounded with the fact that Black women overall are 3 times more likely than white women to die because they were pregnant and 3 times more likely to suffer severe complications like fibroids, the added risks for Black pregnant people of being incarcerated during pregnancy are high. In New York City, 52 incarcerated people were reported last year as pregnant by Correctional Health Services.

In a 2025 report produced by the Arnold Institute for Global Health, New York City's partnership, interviews with individuals who gave birth while incarcerated in New York City revealed gaps in both the medical and correctional systems. The systems often lack mattresses sufficient for pregnancy support, nutritious foods, outdoor time, and fresh air. Safety from hazards such as mace and mold, and supplies and support for lactation.

Participants also shared that they had limited access to the type of information about pregnancy and childbirth that would be available in the community, such as pamphlets, books, classes, and groups. So today we'll ask what Correctional Health Services and the Department of Correction are doing to address these gaps, and how are they delivering maternal health services to pregnant individuals while incarcerated?

Now I'd like to invite Chair Brooks Powers to deliver her opening statement. Good morning. I am Councilmember Sylvina Brooks Powers, Chair of the Committee on Criminal Justice. I want to join Chair Farias in welcoming everyone to today's hearing on maternal health and criminal justice. Pregnancy, childbirth, and postpartum period require consistent medical care, appropriate nutrition, access to reproductive healthcare, and support for both physical and mental health.

These needs do not disappear when someone enters the criminal legal system. Pregnant and postpartum people who are incarcerated need the same timely access to appropriate care to protect their health, And the health of their children as any other New Yorker. People who are pregnant while in custody face additional challenges in accessing healthcare. They rely on correctional health providers and facility staff to identify pregnancies, coordinate prenatal appointments, respond to medical complications, and provide care after delivery.

Interruptions in treatment, delays in referrals, or gaps in communication can have serious consequences. Mental health needs also require attention throughout pregnancy and after childbirth, including screening for perinatal mood and anxiety disorders and ensuring that people experiencing serious symptoms receive appropriate treatment. Next slide, please. New York City has taken steps to establish requirements and services for pregnant people in custody, including requirements related to reporting pregnancy outcomes and access to prenatal and postnatal care.

However, it is important to understand how these requirements are implemented in practice, how care is coordinated between the Department of Correction and Correctional Health Services, and whether people in custody are consistently Thank you. Today the committee will examine how Correctional Health Services identifies and supports pregnant and postpartum people, including the procedures used during intake to identify pregnancy, recent childbirth, and breastfeeding.

The committee will also consider the healthcare needs of pregnant and postpartum people in the city's planned borough-based jail facilities. As the city develops these facilities, it is important to understand how their design, medical spaces, staffing, and service arrangements will accommodate pregnancy, childbirth recovery, breastfeeding, and the needs of parents and their infants. Planning for these needs requires more than providing medical space.

It requires clear procedures and appropriate resources to ensure continuity of care. Thank you. This hearing will provide an opportunity to understand what data are available on pregnancy and maternal healthcare in custody, how the city monitors the quality and timelines of care, and what challenges remain in ensuring that pregnant and postpartum people receive appropriate treatment. In addition to today's topic, the committee will be hearing introduction number 902.

Sponsored by Councilmember Lee in relation to mental health protocols for pregnant and postpartum individuals in the custody of the Department of Correction. We will also be hearing resolution number— resolution numbers 467, 497, and 498. Resolution 464, also sponsored by Councilmember Lee, would call on the state to pass legislation recognizing postpartum mental illness as a mitigating factor in criminal sentencing.

Resolution 497, sponsored by Councilmember Hudson, recalling the state to pass Senate Bill 2667C and Assembly Bill 1670A, which would prohibit the use of restraints and limit other uses of force on pregnant and postpartum women. Thank you. individuals in the custody of law enforcement. Finally, Resolution 498, also sponsored by Councilmember Hudson, would call on the state to pass legislation allowing pregnant people to postpone court proceedings when in the later stages of pregnancy.

These pieces of legislation are meant to support pregnant people who have contact with The criminal legal system, a system where being pregnant or postpartum only amplifies the opportunity for trauma one can experience. I would like to thank my staff and committee staff for their hard work. Jahari Frazier, counsel to the committee. Chad Benjamin, policy analyst. Casey Lasky, financial analyst.

Owen Brady, my policy and budget director. And Renee Taylor, my chief of staff. I look forward to a productive discussion with the Correctional Health Services, the Department of Correction, the Board of Correction Advocates, and other stakeholders about the care available to pregnant and postpartum people in custody, the challenges they continue to face, and the steps needed to ensure that their medical and mental health needs are appropriately addressed.

Thank you, Chair Farias, and I will turn it back over to you.

Thank you so much, Chair Brooks-Powers. Today the committees will also consider the following legislation: Intro Number 1144, sponsored by Councilmember Rita Joseph, myself, and Councilmember Farrah Lewis, in relation to requiring a report regarding an analysis of gender-based violence in the city. And as you've already heard from Chair Brooks-Powers, Introductions 902, the committees also are considering Resolutions Numbers 464, 497, and 498.

Finally, I'd like to thank committee staff Julia Goldsmith-Pinkham, Katie Salina, and Allie Stauffer, as well as my own staff, Daniel Curtin, for all of their work on today's hearing.

I'd like to remind everyone who wishes to testify in person today that you must fill out a witness slip, which you can find on the desk of the sergeant-at-arms near the entrance of this room. Please fill out a slip even if you have already registered in advance that you will be testifying in person today. If you wish to testify on any legislation, Please indicate on the witness slip whether you're here to testify in favor of or in opposition to the legislation.

I also want to point out that we will not be voting on any legislation today. To allow as many people as possible to testify, the testimony will be limited to 2 minutes per person, whether you are testifying in person or on Zoom. I'm also going to ask my colleagues to limit their questions and comments to 5 minutes.

Please note that witnesses who are here in person will testify before those who are signed into the Zoom webinar. I will now turn it over to the committee counsel to administer the oath. Good morning. In accordance with the rules of the council, administer the affirmation to the witnesses. I'll call on you each individually for a response. Please raise your right hands, including folks who may be called up to answer additional questions if you have more than the 4 of you.

Please raise your hand— right hand. Do you affirm to tell the truth, the whole truth, and nothing but the truth before these committees and to respond honestly to councilmember questions? Thank you. You may begin. You may begin when ready. Much better. Thank you.

Good morning, Chair Brooks-Powers and Chair Farias and members of Committees on Criminal Justice and on Women and Gender Equity. My name is Nancy Arias and I serve as the Chief of Nursing for New York City Health and Hospitals Correctional Health Services. I am joined by my CHS colleague Jeanette Merrill, Senior Assistant Vice President of Communications and External Affairs.

We appreciate the opportunity to testify today on maternal health and criminal justice. Since 2016, CHS has been the direct provider of physical and mental health services to people in the custody of New York City Department of Corrections, DOC. Women comprise about 8% of our patient population. and have significant clinical and social medical needs. Based on September 2026 data, 82% of the women in our care were enrolled in the mental health service. 47% of women were diagnosed with serious mental illness, and 34% of women had an opioid use disorder.

We recognize the tremendous responsibility and opportunity we have to provide high-quality health services, including perinatal care, to our patients. Last calendar year, there were 52 pregnant individuals in total in our care. For many of our pregnant patients, their connections to community-based healthcare and support networks have been disrupted by their incarceration, making the services CHS provides especially important.

Other pregnant patients may have been out of care in the community due to challenges accessing providers or navigating services, presenting an opportunity to engage them in prenatal services that can promote maternal-fetal health. CHS medical and nursing professionals conduct a comprehensive medical evaluation of all individuals when they are admitted to the New York City jail system. At the Rose M.

Singer Center, RMSC, or Rosie's, clinical staff obtain a reproductive health history and offer pregnancy testing to all reproductive-age patients. Okay. Sorry. Based on the information obtained during the intake assessment, Patients may be referred for follow-up medical care or to the mental health service for additional evaluations. Postpartum patients can be referred to CHS's obstetrician for a postpartum visit or well-woman care, which may include pelvic exam, Pap smears, breast exams, or other reproductive and sexual health services.

For patients who are pregnant at the time of jail admission, CHS clinicians order prenatal labs and vitamins and make referrals to the CHS obstetrician for prompt follow-up care. Clinicians will work to obtain collateral information if the patient was engaged in care in the community. All pregnant patients receive routine prenatal care at Rose M. Singer, where they have access to on-site ultrasounds as well as pregnancy-related education, including information about breastfeeding.

A member of CHS's Gender-Related Services team, which is part of CHS's Reentry and Transition will meet with the patient to offer additional support and information. Patients with more complicated clinical profiles also receive care in coordination with our colleagues at Elmhurst Hospital. To help orient all pregnant patients to the obstetric services available to them, CHS schedules joint introductory telehealth visits that include the patient, the CHS obstetrician, and the Elmhurst Hospital obstetrician.

Throughout the individual's pregnancy, our providers work closely with the labor and delivery and maternal fetal medicine providers at Elmhurst Hospital to coordinate care. At Elmhurst Hospital, our patients see a member of the hospital's care team who will be present should they deliver in custody. As previously mentioned, patients may also receive advanced prenatal testing and procedures at the hospital when clinically indicated.

For both routine and high-risk pregnancies, CHS and Elmhurst medical providers conduct joint specific case conferences, which can also include clinicians from CHS's mental health service. Patients who go into labor while incarcerated on Rikers Island are transported by FDNY EMS to Elmhurst Hospital for delivery. Patients may apply through DOC's programs to care for and reside with their infants in the Rosie's Nursery, a housing area maintained by DOC with CHS's nurses providing clinical support to the new parents.

For patients who are referred for a mental health evaluation, a licensed CHS mental health provider reviews the patient's full mental health history, interviews the patient, and reviews an extensive social history with the patient. The information the mental health provider obtains during this assessment helps to inform their diagnostic determination, individualized treatment plan, Case management and reentry planning. The information also enables clinicians to assess clinical risk factors and to determine the patient's most appropriate mental health level of care.

CHS provides a spectrum of jail-based mental health care that ranges from individual and group counseling and medication treatment to mental health therapeutic housing units for patients who have more robust mental health needs and require increased clinical observation and care coordination. During all clinical encounters, mental health clinicians assess patients for trauma symptoms and mental health disorders, including perinatal mood and anxiety disorders and postpartum depression, as clinically indicated.

All pregnant and postpartum patients with diagnosed mental health disorders are closely monitored by CHS's mental health service. Should a pregnant or postpartum patient require a higher level of psychiatric care than can be provided on Rikers, the patient will be referred to Elmhurst Hospital in coordination with CHS and hospital leadership. Many of our pregnant patients have complex medical and psychiatric comorbidities and require robust care coordination and treatment plans.

CHS's reentry and transition service helps connect patients to clinical resources in the community to help ensure continuity of care All pregnant and postpartum patients and all patients receiving mental health services receive an individualized discharge plan in addition to the core reentry services available to, to all patients, which includes assistance applying for Medicaid. CSS reentry staff coordinate with DOC and their contracted vendors to support transition planning as appropriate, including referrals to housing.

In addition, Elmhurst Hospital obtains contact information for all pregnant patients, and hospital social workers are available to support delivery plans and follow-up care after release from jail. Intro 902 would require the establishment of protocols governing the identification, screening, referral, monitoring, and follow-up care of pregnant individuals and postpartum individuals in DOC custody who have or may have mental health needs.

As written, the bill will require DOC to establish and maintain these protocols, but CHS is the direct and independent provider of medical and mental health services to people in DOC custody and will serve as the appropriate agency. The protocols outlined in the legislation largely align with current CHS practices, as they relate to referrals to care, mental health screenings, psychiatric evaluations, clinical documentation, and discharge planning.

However, we would want to refine the language to ensure the bill doesn't legislate clinical decision-making and ensures that CHS can continue to provide care in accordance with the most current and appropriate standards of care and clinical practice. We would like to discuss with counsel the provision of the bill that would require CHS to establish procedures for identifying postpartum status when an individual does not proactively disclose such status.

CHS providers work to establish a relationship of trust with our patients, which can prove more challenging in a carceral setting. All of the services we provide are voluntary, and we respect every patient's right to engage in clinical services And to provide personal information as the individual feels comfortable doing so. We would therefore appreciate the opportunity to better understand the intention of the Council relative to this specific provision and to explore ways to address any concerns without jeopardizing the sanctity of the provider-patient relationship and while protecting the privacy and rights of the patient.

Thank you, and we look forward to answering your questions. Thank you. And you will now hear testimony from our colleagues at DOC.

Good morning, Chair Brooks Powers and Chair Farias and members of the committees. My name is Valerie Grasock, and I'm an Assistant Commissioner within the Division of Programs and Community Partnerships. Thank you for the opportunity to discuss the New York City Department of Corrections' support for pregnant and postpartum women in our care. As our colleagues at Correctional Health Services have described, CHS provides medical and mental health care within the jails, while DOC facilitates access to that care through appointments, transportation, referrals, and necessary accommodations.

Our responsibility also includes supporting individuals in our care as they prepare for childbirth, recover following pregnancy outcome, and care for their children. Through our partnership with the Caribbean Women's Health Association, the DOC offers doula services to individuals housed at Rose M. Sanger Center. Doulas provide non-medical physical, emotional, and informational support, including birth planning, Breastfeeding education, newborn care, and support following pregnancy loss.

Services are offered twice weekly with labor and delivery support available upon request. From January through June of this year, the program served 20 women and provided over 400 hours of support. DOC also operates a residential nursery at RMSC where eligible mothers can remain with their infants until the child's first birthday. Participation in the nursery program is completely voluntary.

Not all individuals who are eligible want to participate, and admission decisions consider the best interests of the child. The program supports early, early bonding and parental care with an early educational counselor helping mothers meet their baby's needs. We recognize that pregnancy and early parenthood can be especially difficult during incarceration. These programs help women in our care access practical guidance, personal support, and opportunities to build and maintain their relationships with their children during a very difficult time, and we're proud to offer them.

Thank you for the opportunity to share about these important services, and we welcome your questions.

Thank you for your testimony. I'll now turn it over to Public Advocate Jumaane Williams for his remarks. Thank you, Madam Chair. Morning. As mentioned, my name is Jumaane Williams, Public Advocate for the City of New York. I want to thank Chair Farias and Chair Brooks-Powers and members of the Women and Gender Equity and Criminal Justice Committees for holding this important hearing and for the opportunity to share testimony.

Pregnancy, childbirth, and the postmortem period are significantly physically and mentally demanding, and those needs do not change in any way when a pregnant person is incarcerated. Those in custody must be able to access timely, appropriate medical care, receive necessary mental health support, and be treated with dignity throughout pregnancy, childbirth, and the postmortem period. The American College of Obstetricians and Gynecologists, ACOG, in particular emphasizes the importance of incarcerated individuals receiving high-quality, trauma-informed, and comprehensive medical care.

Unfortunately, incarcerated pregnant persons frequently do not receive adequate care due to systemic gaps and hardships, sometimes barely humane conditions across correctional systems. Pregnant and postmortem individuals often face a variety of medical and emotional challenges, including complications during pregnancy, the physical demands of childbirth, and mental health conditions that emerge or worsen during pregnancy or after delivery. These conditions are often exacerbated by the failure of many jails and prisons to provide full access to medications for opioid use disorders, or the abrupt stoppage of treatment postmortem, increasing overdose risks.

Dehumanizing treatment reported by incarcerated pregnant people, including inadequate prenatal monitoring, delayed responses to obstetric symptoms, isolation during delivery, and the traumatic use of shackles during labor, a practice banned in New York in 2009. In addition, the rapid post-delivery separation from newborns remains a deeply distressing reality in most facilities and has led to increased rates of postmortem depression.

These concerns are particularly important in correctional settings where individuals must rely on the facility to access care. Today the council is hearing Intro 902 by Councilmember Lee, which would require the Department of Corrections, in coordination with the Correctional Health Services, to establish and maintain written protocols related to identification, screening, referral, monitoring, and follow-up of pregnant and postmortem individuals with mental health needs.

These specific protocols will be made public available and shared with all staff involved in their care. This would address the importance of keeping a reference point so that all health concerns can be properly addressed. It is imperative that these protocols support timely referrals, appropriate psychiatric evaluations, and establish coordination between medical and mental health providers. There must be procedures to help individuals maintain access to medications or support services as they transition out of a facility.

The council will also hear Reso 498 by Councilmember Hudson, which calls on the state legislature to pass and the governor to sign legislation to postpone court proceedings as requested by individuals in the later stages of pregnancy. Court appearances often involve transportation, arraignment, processing, and prolonged waiting, which often imposes substantial burdens on individuals who are also close to birth, which can often lead to deeply disturbing incidents in the courtroom akin to what happened in May with Samantha Randazzo, who gave birth while shackled in a courtroom in Brooklyn.

Res. 497, also by Councilmember Hudson, will call on the state to pass and governor to sign a bill in relation to prohibiting the use of restraints on incarcerated individuals during labor, absent extraordinary circumstances, on pregnant persons during custodial interrogation. It is important that no individual should be shackled during deeply vulnerable medical critical moment. The safety, dignity, and peace while giving birth must be paramount.

It is essential that what happened to Luz Burke, who was put in full body restraints while she was pregnant and retained in Rikers Island, does not happen to anyone. These proposals raise broader concerns about the legal system Accommodates pregnancy and recovery. We must ensure that staff and health providers fully understood their responsibilities and their medical needs are addressed properly— promptly.

We must also ensure that decisions about court appearances and custody do not needlessly interfere with continuum of care. Looking forward to the administration, hearing from them about how it's ensuring timely equity in maternal health care for pregnant and postpartum individuals in custody. What procedures are in place to maintain continuity of care as those in custody are transferred across facilities and how the city can further help in ensuring all people receive adequate care pre- and postmortem.

And I— it's the— I have to mention that obviously when we hear these stories, it's usually Black and brown women who are going through this, and I'd be remiss if I didn't mention that. Unfortunately, usually the case. Thank you for this hearing.

Thank you so much for your testimony, Public Advocate Williams. I'd now like to invite Councilmember Hudson to give remarks about her resolutions. Thank you so much, chairs, for the opportunity to speak on 2 resolutions that this committee is hearing today. Earlier this year, New Yorkers were confronted with the deeply troubling news of a pregnant woman who went into labor while handcuffed and awaiting arraignment in Brooklyn Criminal Court.

That incident raised urgent questions about how our justice system treats pregnant people. Resolution 497 calls on the state to pass legislation prohibiting the use of restraints on incarcerated individuals during labor, delivery, and postpartum recovery. and extends protections to pregnant people during custodial interrogations. Childbirth requires the ability to respond to rapidly changing circumstances. Restraints put both the person giving birth and their child at risk.

Resolution 498 calls on the state to pass legislation allowing court proceedings to be postponed at the request of individuals in the later stages of pregnancy. No one should have to choose between protecting their health during pregnancy and navigating the demands of the criminal legal system. A temporary postponement can provide the time needed for childbirth and recovery without ending a case or eliminating accountability.

No one should be shackled in labor. No one should be forced into a courtroom days before giving birth, not for any charge, not for any reason. We have an opportunity to close gaps in our laws and ensure that pregnant New Yorkers are treated with the care and respect their circumstances require. I urge the state legislature to pass these protections and the governor to sign them into law.

Because dignity does not end at the courthouse door. Thank you.

Thank you so much, Councilmember Hudson. I'll now jump right into questions. At what points during intake and detention are individuals screened for pregnancy? Sure. So I'm Jeanette Merrill, Correctional Health Services. So as part of the routine new admissions process, everyone who to Rikers receives a comprehensive medical evaluation conducted by our nursing and medical staff. So at Rosie's, that includes, for all women of reproductive age, pregnancy testing, and then women who are found to be pregnant are scheduled with the CHS OB-GYN for additional examinations.

Okay, and who's conducting the pregnancy screenings and what trainings do they receive beforehand? So that would be our nursing staff. Okay. So actually, our patients receive 3 levels of screening. So our first individual that they'll encounter will be a patient care associate, who will be the one who does the point-of-care testing and will be then doing the urine screening with the urine dipstick.

And then they subsequently see a person of a higher license to complete their intake, which would be a registered nurse and also followed up by a nurse practitioner. And are the registered nurses and the nurse practitioners hired by DOC, or are they— Correctional Health Services. Correctional Health Services, sorry. And they're regular staff there at Rikers, or do they— are they per diem by any chance?

So we have— well, we have persons who are hired specifically to work at Rose and Sing Sing. Got it. And, you know, there are obviously many Potential possible complications during pregnancy. What's the protocol when someone experiences a medical emergency? So as all our patients, a medical emergency is initiated at the housing level where the individual is at, and we coordinate with the Department of Corrections to facilitate response to the unit.

Correctional Health Services are the first responders to the unit to assess and stabilize the patient, and then we would escalate based on the clinical assessment of the patient at the time. Okay, and are staff trained to recognize warning signs like vaginal bleeding, contractions, fluid leakage, severe abdominal pain, etc.? Yes. Okay, and then in terms of the administrative code requiring that doula services be provided at a frequency of at least twice a week for 4 hours with at least 2 doulas available.

Does DOC follow this minimum or does it provide greater access to doula services than that? Thank you for your question. Yes, we have a wonderful partnership with the Women's Caribbean Health Association and they are at Rosenzweiger at least twice a week for 4 hours each day. Okay, and how— sorry, how many doulas currently provide services to people in custody at DOC?

2 doulas. 2 doulas. And just give me their— how many days per week they're available, usual hours of availability. They're typically on site twice a week for at least 4 hours, sometimes longer. Okay. There was a massive jump in service hours provided by doulas in the last 2 reporting periods. Compared to before, with doulas providing 426 service hours from January to June of 2026 and 438 service hours from July to December of 2025, as compared to 148 service hours for January to June of 2025.

Is there a specific reason that doulas were able to provide so much more service over the past 12 months? I think doula services are very important and very valued by the individuals in our care. Although the minimum is 2 days a week, oftentimes they do come on the 3rd day because the women often ask for them. They're often kind of like their main go-to and they really serve as a source of important emotional support.

So I've found that they often come additional hours. Are they compensated for those hours? Yes, we have a contract. Okay, great. And what organization or what vendor is contracted for doula services currently? It's an organization called Caribbean Women's Health Association. They've been a wonderful partner since the beginning. Great. And that contract is through DOC or CHS? It's a contract through DOC.

DOC. How long have we had that contract? Is there like an open RFP, RFA, or have we had it for an extended time period? We've had it for at least several years. We've been renewing it with a contract for 2 years, and the current contract is for 1 year. But every year we renew this contract, and we're actually looking to increase our investment in doula programming because the feedback has been overwhelmingly positive.

Great. Is— sorry, just for my own clarification, is typically the contract for 2 years, or is it 1 year with option to renew for an additional The current one is for 1 year. For 1 year. Okay. Have there been any other vendors that we've used in the past with DOC for doula services that's provided to folks that are incarcerated?

So we follow the procurement rules when we release the solicitation, and this vendor has been selected during this period and the previous period based on their extensive experience working in the city and with women and with justice-involved women. Okay. Sorry. Remind me again, when did we start providing doula services at DOC? We started the year that the law went into effect.

Okay. And how many facilities can the doulas access, or is it just for Rosie's? So their contract is to serve anyone in our care who is pregnant. So they typically facilitate services at Rose Emsinger, but the goal is for them to be able to serve anyone who is pregnant or postpartum. And that's in the contract? Yes. Okay.

And can someone walk me through the process that a doula has to follow to enter the DOC facility? Is it like a person from the public? Or are they a staff member? For all of our contracted providers and volunteers, there's a volunteer ID process. The doulas submit a volunteer ID application. Once they receive an ID, they have an ID that allows them to access the facility.

So they can go directly to the nursery or to any other housing area to meet with women where they are. Okay. And then For procedures around individual reports for possible— what procedures are followed from folks when an individual reports a possible pregnancy after intake? Let's say we did not catch it. They would go through the same process.

It would still be a referral to our CHS OB-GYN for— we would order prenatal vitamins and labs and then potentially coordinate with Okay. And in the past 3 calendar years, how many pregnant people in DOC's custody missed scheduled prenatal or obstetric appointments because they were not produced by DOC? And if you can possibly— if we have those by year, that would be helpful.

Sure. So in calendar year '25, 53% of on-island obstetric appointments were non-productions. But I should note that is the initially scheduled appointment. If an individual misses that first scheduled appointment, we coordinate to reschedule and then can always escalate as needed at the local level to ensure the woman has access to care. So again, 53% non-production for on-island, and then off-island, meaning Elmhurst Hospital, is 40% non-production.

And then calendar year '24, on-island, 37% nonproduction, 43% for off-island. And then calendar year '23, on-island, 27% nonproduction, 69% off-island nonproduction. Got it. And in each of these, 3 calendar years, how many people in DOC custody were transported to a hospital for labor and delivery or a pregnancy-related emergency? So fortunately, very few women are still in custody at the time that they deliver.

But between calendar year 2023 and 2025, there were 15 individuals who gave birth while in custody and would've been transported to Elmhurst for labor and delivery. Okay. And how many of these incidents involving the use of— were involving the use of restraints on pregnant or postpartum people in DOC custody were recorded? Good morning. Chelsea Chard, Senior Advisor.

We have zero reported incidents within the past 3 years. Is there a reason why we have zero reported when we know of at least one case? We have zero recorded, period, of no restraints being utilized despite some of the records that folks are giving to us? I wouldn't be able to speak to those individual cases. It is our policy that in the case that DOC knows that an individual is pregnant or 8 weeks postpartum, restraints are to be used only as an absolute last resort.

And in the case that restraints are used, a report is generated, a positive report is generated to our state oversight body, and we don't have any of those reports for the past 3 years. Okay. Can you give me an idea of how that process works? Like, who's in the room when there's potential use of restraint and who has to elevate that or generate that report?

Sure. So generally it would be the staff who are with that person, whether it's during transportation or kind of wherever they might be within a facility or a clinic setting. Again, the goal is to never have to use restraints. There is a lot of de-escalation and work that happens with that person, whether it's from DOC staff or other staff who might be present in the room.

In the case that there is imminent risk of harm to the person or to others. That would be really the only case, and that is, again, exceptional and rare. And in those cases, only front restraints are used, and the person who is applying the restraints is the one who is submitting that report within 1 business day. Okay.

Thank you so much. I'm going to now pass it over to Chair Brooks Powers for her questions.

Thank you so much, Chair. Thank you for the testimony. Again, it's always helpful if we could get the testimony in advance. So my hope is that I'm not redundant in some of the questions that I'm asking. Going back to screenings for pregnancy, postpartum status, how is medical information shared between NYPD and DOC when someone changes custody? Sorry, that's between NYPD and— Department of Correction.

Sorry, can you repeat the question? Sure. How is medical information shared between NYPD and DOC when someone changes custody? So when they're going from being in custody with the NYPD And they're being transferred over to the Department of Correction to be in custody. How is that information shared for an individual that is pregnant? NYPD doesn't share medical information with us.

They would go through the medical screenings that are happening at the courthouse. But is there any documentation or anything to denote, like, this person in custody is pregnant, or any type of dynamic? Not that I'm aware of. Are pregnancy and postpartum screenings conducted only at intake, or are they repeated during detention? So it would be as clinically indicated.

Primarily, it would occur at intake, but of course, patients have the right to refuse services as well, so a subsequent clinic appointment could occur. address perinatal needs. So they're offered even beyond intake? Yes. Okay. What procedures are followed when an individual reports a possible pregnancy after intake? So at that point, the individual would be referred to the CHS OB/GYN.

We would order labs, vitamins, and then start the coordination process And how does the department ensure that CHS is promptly notified when a person is identified as pregnant or postpartum? So CHS would identify a pregnant— a patient as pregnant or postpartum, and then according to New York State correction law, a woman or patient who is within 8 weeks of pregnancy But in terms of DOC, how are they ensuring that CHS is promptly notified— promptly notified when a person is identified as being pregnant?

Because they're coming into care first at Department of Correction, correct? Pregnant. Sure. So someone would— when someone's coming in through intake, the first step that they're doing once they're on Rikers Island is going through that intake screening process. And the intake is done by CHS? Correct. Okay. There's generally not a case where DOC would be notifying CHS.

It would be occurring the other way around because we don't hold that medical information and we don't require people to disclose to us. Got it. What is the racial demographic breakdown of pregnant people in Department of Correction custody over the last 3 calendar years? So CHS doesn't collect racial demographic information, although if it's clinically indicated, we would seek that from the patient.

We do know, as was mentioned in testimony, that the majority of women in our care are Black and brown women. Black women in particular have higher risks of pregnancy and childbirth-related incidents. So really, we're treating every pregnancy see by nature of the woman and the patient being in custody as higher risk. So we're not stratifying by race in that way.

Sorry. Thank you.

Going over to the nursery program, where is the nursery located within the Department of Corrections system? Thank you for your question. The nursery is located within the Rose Emsing Center. And how many beds and cribs are available, and what is the maximum occupancy? The maximum occupancy is about 15, 15 rooms for a mom and also children. Are mothers able to keep their infants with them throughout the day and overnight?

Yes, yes, they are. What is the current operational status of the Department of Corrections Nursery Program? Thank you for your question. We are proud to offer one of the country's oldest correctional nurseries, and so the nursery is fully operational. We have a mom currently Inside the program, we have a wonderful partnership with Caribbean Women's Health Association, as I mentioned earlier, to provide doula services and help mom around newborn care, emotional support, and recovery after childbirth.

We also have wonderful partnerships with Our Children, which provides reentry support inside the nursery. And, you know, it's really designed to look and feel like a nursery. cribs and children's toys and books and rocking chair for the mom. And it's really kind of designed to support the care of the mom and the child. And actually last year we completely renovated the nursery and purchased all new furniture, new cribs, new toys, new books.

We painted the walls, we did the floors, all with the goal of making sure that it's a welcoming and warm environment for Are there any— are there enough slots for every birthing person in Department of Corrections custody to avail themselves of the nursery? Yes, absolutely. And I know you mentioned just now that there was a mother right now in the program.

Is there only one person that either has an infant or that is pregnant right now in custody? There's currently one mom and an infant in the nursery. There are other individuals who are pregnant. And so are they located still in general population? They are. Oh, because on my last visit, I was— I raised concerns about that, and I know Commissioner had mentioned that effective that day, they would be moving, um, those in custody that are pregnant into the nursery, um, for safety reasons.

Hi, my name is Nell Colon. I'm the Deputy Commissioner of Programs and Community Partnerships, and I was on that visit. Um, I just want to emphasize that, uh, while there is only one, um, individual in the nursery right now with their child, all of the women who are pregnant actually after that visit have been afforded and offered the opportunity to move into the nursery.

It is a voluntary move, but we have been ensuring that the application is presented and that they are given the opportunity to apply. And we currently have an application pending. So, so they have to apply to be moved there? Yes, they do. Can you explain that to me? Yes. So In order to move into the nursery, a screening does occur.

Part of it is with medical and mental health, but notably it also is with the Administration of Children's Services. So taking into account of any cases of child abuse or neglect that may be indicated by ACS. Mm-hmm. And with that, those 2 pieces of information information are then reviewed by the department, and very often, if cleared, they would be moving into the nursery.

And only one of the pregnant moms have applied and the rest have refused? Well, the program is voluntary, and we also have a transient population, so we might have had someone who was pregnant last week and then they might have been released. And so everyone who is pregnant who is in our care now is offered the application.

Some of the moms chose not to complete the application, and we currently have one pending. Do we have an idea of why they refused? I think a lot of times they anticipate being released before giving birth. What supports are available to parents and children in the nursery program? Thank you for that question. So the doulas are on site at least twice a week, and they help the mom around newborn care, anything from diapering, breastfeeding, any kind of emotional support that's needed.

We also have a team of counselors that are regularly inside the nursery. So we have a social worker and a correctional counselor that provides one-on-one support, coordination with other programs, coordination with CHS, assistance with any paperwork. They're sort of the, the main go-to for any kind of key DOC services. Our Children has a presence in the nursery as well.

They primarily support around reentry, and they also coordinate with a network of other nonprofits that have a presence at or Rose and Singer Centers. That includes the Women's Prison Association, Osborne Association, New Hour, and Home Base. There are other services that are available as well. For example, chaplaincy, and of course, any mandated services. We also have an early childhood education counselor who is at the nursery providing support as well.

Going back to your statement about the application process, Are notices regarding the nursery and potential eligibility posted anywhere besides the clinic? And if so, where are they posted? I believe they're posted in intake as well. I would also note our gender-related services team meets with every pregnant individual in custody, and part part of the work they're doing is facilitating access to nursery applications.

What's the longest someone can remain in the nursery? So with a child, you can remain up to 1 year. That's not When children age out of the nursery program, has the Department of Correction noticed any negative effects on the parent or— on the parent if the parent remains incarcerated? I think what I can say is our DOC program staff and the doulas work very closely with the mom to support her. coming up to that time.

We've even had a birthday for the child, their first birthday. There's a lot of counseling and support because we recognize that being a new mom can be difficult when incarcerated. As part of the postpartum visit, there are mental health screening questions if the woman weren't already enrolled in the mental health service, and we do have a very low threshold for those referrals.

Just pivoting to borough-based jails. What is the Department of Corrections plan, current plan for housing women and gender-expansive people after Rikers Island closes? Thank you for your question. I think there's a few things that are being explored right now for how we're supporting both women and gender-expansive people after Rikers. At this time, I believe there are plans for us to consider the Queens Detention Center, although I think other options are being looked into right now.

That's good to know because the current plan states that there'll be 450 beds for women and gender-expansive people at the Queensborough-based jail and One, I'm curious as to how we came to that number, and 2, why are we limiting the location for women to one location, considering that majority of the women that are in custody are often the caregivers in their household, placing a burden on them when the men are in their respective boroughs?

So I'm just curious how we decided that the women had to be in one borough. Yeah, that's a good question, um, because it's been a lot of planning, um, and I think there has been some conversation back and forth as we've solicited community feedback. I believe most of the, uh, numbers that we were talking about in terms of bed space were based on previous projections, as, you know, kind of years ago these were coming to fruition.

Um, and my understanding is, um, similar to sort of how we operate on Rikers, we recognize that when we have certain Certain populations, they need specialized services, and in order to offer those specialized services, it can be helpful to have them all in one location so that all of those services can kind of be hubbed in that location as well.

I believe that was part of the thinking in terms of designing it in that manner. How many women are in custody now today? If you give me one second, um, 482. Okay, so not far from the 450. Is there an opportunity to revisit having women in just one location? Well, I would say I think there is an opportunity for us to consider a variety of ways that we can support women before they even come into our custody.

And so I think the city is open to, to But to be clear, in terms of the construction and the design of the 4 borough-based jails, is there still an opportunity to accommodate women at more than just the Queens location? Quite honestly, we'd have to get back to you. Okay. I would greatly appreciate if we could explore that.

I think that it is problematic that we only place the women in one, and I've been saying this for the moment it was announced, quite honestly. And as chair now, I want to be able to work with the administration to try to work through that, because we do have folks that whether they're pregnant, they may have kids at home, it just places an extra barrier when the whole idea behind these borough-based included having people being connected to community and connected It's a family.

So I think that it's a bit unfair that we're now saying, okay, except the women, because they require different levels of care. I think it's the obligation and the responsibility of the Department of Corrections to ensure that no matter where they are, that they're getting that care.

Restraints. What is the Department of Corrections' current written policy governing restraints on pregnant people? Our current written policy is in alignment with state guidelines. And so I think, as I had said previously, the goal is never to use restraints on an individual who is either pregnant or 8 weeks postpartum. In the case that someone is, you know, having a challenging time, which of course this is, this is a hard time to be pregnant there in jail.

And there is The training is essentially what we would want for any avoidance of, um, you know, using restraints, which is a lot of de-escalation, a lot of talking with a person. Um, you know, I think a lot of our staff have rapport with folks. Um, and so in moments when someone's upset or they're getting escalated in some way, um, there is an emphasis on de-escalating and trying to calm the person down, um, for however long that takes.

Sure. And really only in the case that someone is essentially coming to the point of self-harm and imminent risk of harming themselves is when we would consider using restraints. And the only restraints that are to be used are in front of the body. Okay. And we remove those as soon as the person is calmed down. We don't wait to get to any particular location.

So in the case they need to be used, they're used for as short of a duration as possible. And then, as I mentioned, there is a report that's generated following that. And in the case that restraints are used, the woman is also escorted to clinic or otherwise does receive a medical follow-up after that incident. Thank you. The Chair is going to have some more questions around that.

I just wanted to pivot really quickly for the Department of Correction regarding deadlocking. This is a follow-up from our September 23rd hearing. hearing. So at the Committee on Criminal Justice hearing on September 23rd, I asked General Counsel Conroy to confirm that deadlocking is no longer occurring. He responded that it was not, referencing the DOI, that DOI was unable to substantiate claims about deadlocking from 2024.

Later in the same hearing, Barbara Hamilton of Legal Aid testified that multiple clients have been deadlocked this year, allegations which DOC was surely aware of due to ongoing litigation. Should we understand your previous testimony to mean that those allegations are false? So we can't speak to any of the specific allegations that were made since there's ongoing litigation and legal action.

But I do believe that our position remains with the General Counsel But are you acknowledging that you're aware that litigation is going on right now? I don't work in the legal division, but, you know, I believe there are some legal proceedings related to lock-in, but we can't comment on those specifically. The concern for me is that your general counsel sat before this committee under oath and was unaware at that time about any deadlocking happening.

However, there's ongoing litigation, and that was not acknowledged in his response to me. In a 2025 report, the Board of Correction recommended mandatory reporting of individualized involuntary lock-ins, audits of logbooks and surveillance footage, targeted staff training, discipline where appropriate, and track of lock-in duration and impact on services. Which of these safeguards has Department of So, I know in general, when those allegations were made, again, we referred that immediately to DOI, and their investigation could not substantiate any of those allegations.

Nonetheless, at the time, there was communication and direction given from the top to the bottom that that is not within our policy. That's not something that should be occurring. The department already has reporting obligations related to sexual assault. related to emergency lock-ins, inclusive of duration and any interrupted services. So those reports have remained ongoing. So essentially, there are steps that DOC has implemented to be able to ensure that staff understands that is not permissible anymore through communication, and how are you— but how are you tracking whether or not it's happening or instances if it were to happen?

That should be something that's being recognized by supervisors during their regular touring because, again, it is not policy for that to be occurring. And so, as supervisors and frontline staff are making their regular tours, that's something that should be observed and corrected for. And in the case that policy is being violated, of course, discipline is appropriate. Has the department received any additional allegations regarding deadlocking or involuntary individualized lock-ins in any housing unit in 2025 or 2026?

We'd have to follow up with you on that. While we're in the hearing, can someone just check and see if we can get that while we're here? We'll have to follow up and get that to you afterwards. I don't think that's something we'll be able to confirm right now. In an October 2024 Board of Corrections meeting, former Rikers Island social worker Justina Rezwinski testified that correction officers placed white tags on the cell door switchboard, the panel that can unlock any door in the unit, to indicate deadlocked individuals.

She alleged that this was the only record of deadlocking. In its closing memo for its investigation onto these claims, the Department of Investigation stated that it observed white pieces of paper on 8 different cell control buttons on the cell door switchboard in the control room. Are staff permitted to tag cell door control buttons? I'm not familiar with that policy.

We would have to follow up. Okay. When you follow up, I'm going to just give some follow-up questions pertaining to that. So in the event that white paper tags are permitted, The question then becomes, correctional officers told the Board of Corrections that white tags are used on cell door switchboards to indicate that someone is outside of their cell at programming, at court, but told the Department of Investigation investigators that white tags were used to indicate that the person in the cell had exhibited a certain type of behavior.

What is the purpose of white paper tags on the cell door panel? And if white paper tags are not permitted, the follow-up question is, have any staff been disciplined for placing white tags on cell door switchboards? Has DOC issued any memos or taken any other corrective actions regarding the placement of paper tags on cell door switchboards? Can you confirm that these tags are no longer in use?

And have you conducted an audit to confirm that these tags are no longer in use? And I believe we have a letter that will follow this hearing to summarize everything I said, so you know exactly what we're looking to get from you.

Okay. Thank you. I'll pass it to Chair Frazier. Thank you so much. I just have 2 quick follow-ups before I open it up for questions from members. I do also want to acknowledge that we've been joined by Councilmembers Feliz and Santos-Suazo. On the questions that Chair Brooks Powers asked regarding the racial demographic breakdowns of pregnant people in DOC custody, I understand that CHS's intake, from what I heard in response, doesn't collect that data.

My question is around comprehensive healthcare. If we're— if we know consistently that the folks coming in for intake are going to be predominantly Black women, Latinas, people of color, when we're looking at comprehensive care or continuity of comprehensive care, Wouldn't that be helpful demographic information, helpful information to look at how we're holistically caring for a person within our custody?

So we can always ask on an individual patient level if that's indicated. I think, as you said, the vast majority of women in our care are Black and brown women, and we treat really every woman as requiring— as a vulnerable population. population by virtue of being incarcerated. So that historically just hasn't been information that's informed treatment plans.

And there's no intake form that you folks do where people self-identify? It's not one of the questions on our intake screening. Okay. So there is an intake screening form that we're checking off different questions, but that just isn't a part of it. Okay.

And then just another follow-up from a question that Chair Brooks Powers asked. For the notices regarding the nursery and potential eligibility on moving from general population to the nursery, have we thought through or are their families notified of the potentiality to move their housing? Is that something that we've done in the past or we're interested in doing?

Because maybe sometimes encouragement is needed by— Typically, we communicate directly to the person in our care, and they would communicate with a family member. Okay. Yeah, generally DOC is not in communication. We don't have a means of communicating. And what about like counselors or the doulas? Are those folks talking with family members? And yeah, I think for, for counselors or any of our DOC staff, DOC staff that are even, or non-DOC staff are providers, we do often get consent from the person in our care if they would like us to reach out to anyone else, including their family.

Our social service team at the Rosem Singer Center does a lot of actually facilitated phone calls with a variety of folks from community care providers— Mm-hmm. That may not be able to come onto Rikers Island and families as well. as indicated and necessary. And so during those conversations, it could come up, the opportunity for the nursery. But since it is a consented conversation, we're not necessarily privileged to what that information or the case note would look like.

Okay, I would recommend just talking that through with doulas. Like, sometimes you need your mom, your sister, your partner to tell you this might be best for the time being. And, you know, sometimes folks don't want to feel isolated. They might think the nursery will be isolating, so they want to stay around other humans, which makes sense during a very traumatic experience being incarcerated and pregnant.

But sometimes family support is helpful. I will turn over to my colleagues for questions before I use the rest of my time.

So I'd like to first acknowledge Councilmember Marano, followed by Hudson, for questions. Thank you. Thank you both chairs for highlighting such an important topic. Thank you all for your testimony and for being here. Your testimony described the nursery at the Rose M. Singer Center where eligible mothers can live with their babies until their child's first birthday. And I certainly understand the rationale for keeping mothers and infants together, but there's something pretty extraordinary about the fact that New York City has babies living inside a jail, and I don't know that A lot of New Yorkers are totally aware of this.

So my question is, how many— just to follow up on what Chair Brooks-Powers was asking— but how many infants are currently living on Rikers Island, and how many have lived there over the past 5 years? Currently, there is one infant, and since 2022, we have had 8. What happens when one of those infants has a medical emergency?

Is there a pediatrician on site around the clock, or does that baby have to be transported off of Rikers? So our clinical staff would respond to a medical emergency and then initiate a transfer to Elmhurst Hospital, which is also where babies receive their general routine care. Has the city ever conducted an independent assessment of whether Rikers Island is an appropriate environment for an infant?

As opposed to some alternative secure setting that allows mother and child to remain together? I was going to say I actually can't speak on if there has been an assessment that's been facilitated. I think most importantly, um, what has been assessed is the importance of the parental bonding time and ensuring that we're offering, um, bonding between the parent and the child.

We're discussing women who are pregnant or who've recently given birth, but I think a lot of folks are also concerned about the children who were already at home when their mothers were incarcerated. Does DOC track how many incarcerated women are the primary caregivers of minor children, including children who may suddenly have no parent available to care for them?

So our, our communication with the parent is one of self-report. So while we do maintain knowledge through consent of them sharing with us if they are a parent and the number of children that they have and the ages of their children, it is not something that is tracked via a database. And do you coordinate with ACS or another agency to determine whether those children are safe or being properly cared for?

Yes. While it's true that we don't track some of that information via a database, it, it is part of the new admission intake process to ask that question in order to assess whether there may be a child at home who has been left without care or otherwise, such that we would need to coordinate with the Administration for Children's Services.

Could a mother be incarcerated in our city's jail system While nobody in city government has any idea where her young children are or who's looking after them? Um, again, that is part of, uh, the new admission screening process on our end. That's a question that's asked. Of course, if someone doesn't disclose, we wouldn't necessarily know that, but, um, that is part of the question asked, and I, I would hope that a parent would provide that information so that their child can be cared for.

I'll let— sorry, go ahead. I was just going to share and highlight that we have a team of DOC staff and also like a dedicated program specifically to support mothers and kind of encourage the mothers in our care to share that and get services. So for example, we have a family visiting assistance program with Our Children Osborne Association that provides that parenting support to everyone who is a mother.

And so typically they share with us and there's ongoing support around visitation and child-friendly spaces and support for other family members as well. I'll end with this.

I have to ask about the city's plan to close Rikers Island because I think that's probably going to have ramifications across the board, including with respect to what we're talking about here. We're talking about— we're talking today about a population with very specialized needs, and we've discussed maternity care, mental health treatment, a nursery, coordination with Elmhurst Hospital.

Under the borough-based jail plan, where exactly would the maternity and nursery services that are currently provided at the Rose M. Singer Center be located? As mentioned, right now it is slated for the Queens Detention Complex, so that is where we are building. But the capacity there would be— was it 482? We currently have 482 women in our care.

It's approximately 450. Thanks very much.

Recognizing Councilmember Hudson. Thank you so much. I just wanted to ask a few questions about restraints. Are medical personnel consulted before restraints are applied to a pregnant person? I don't think we've had any specific incidents in recent history that I can call to mind, but I think generally what would be occurring is someone, someone who is kind of in imminent risk of harm against themselves or others.

So in that case, if there's— if we are trying to prevent harm imminently and de-escalation and all that hasn't hasn't worked, then we would be applying the restraints directly to prevent harm immediately. Without consulting a medical professional? In some cases. And then can a medical provider direct DOC personnel to remove constraints— restraints, excuse me? I'm not aware, but I don't believe so because, again, the situations in which restraints would ever be contemplated would be, again, very rare and someone who is at immediate and kind of immense risk of harm.

As I noted previously, we're not waiting until we get to a certain location or a certain thing to happen to remove those restraints. As soon as the person is calm and it's safe to do so, the restraints are removed so that, you know, we can prevent further harm. Okay. And has DOC reviewed or revised its restraint policy in response to incidents I don't believe it's been revised in the past few years, although I'm not aware of specific complaints that we would have received that would have necessitated that.

Again, it's extremely rare that this would occur, and we don't have any incidents, I think, going back as far as 6 years. Okay. Thank you.

And then What were the annual expenditures for pregnancy-related medical care for people in DOC custody in each of the past 3 fiscal years? Right. So CHS doesn't budget by clinical condition or diagnosis, and we're not, you know, budgeting per patient. Rather, about 80% of our entire budget is devoted to staffing. So most of the pregnancy-related care would be in direct patient services.

And we do have an OB-GYN and then a recently retired, although we're looking to fill, a prenatal nurse position. So those are really exclusively devoted to prenatal care. But in general, it's members of the staff from the mental health service, gender-related services team, pharmacy, medicine in general that are supporting that care. And how long has that prenatal nurse position been vacant?

I can't remember the exact day. I apologize. It's greater than a month's time. Greater than a month's time. And— And we're actively hiring, looking to hire. What's the average time for hiring medical personnel, like positions like that, would you say? Well, once we identify an individual, the onboarding process usually takes about, I would say, 6 to 8 weeks.

It's just a matter of interviewing and identifying the appropriate candidate. And so are there— is that the only prenatal nurse position, or are there others? We only have one prenatal nurse on staff. Okay, so nope. So there's currently no— everybody's going without a prenatal nurse? No, so that's not— there's a prenatal nurse line. However, there are other RNs that work in the environment that can fill that position until that line is filled, if needed.

Okay. And what was the annual expenditure for the doula program in each of the past 3 fiscal years? So, sorry, I keep making that noise. So our contract was approximately $200,000 spanned over 4 years. So that averages to about Thank you. Thank you, chairs.

Thank you so much. Um, just a question, some questions around restraints. Can we verbalize the actual current written policy that's governing restraints on pregnant people in DOCs? Can you, can you give us the written policy? What is the current written policy? How it's framed? The verbiage? I believe that the verbiage generally is in alignment with, with the state law and the SCOC outlines.

It occurs in a couple places, both in our general restraints policy, but also there is a specific policy in relation to pregnant and postpartum individuals, just so that it's clear and everyone receives the training regardless of where they're working. Can you send us that policy after this so we can read it? I can confer internally. Yeah, thank you.

Um, so you folks have already stated that there's been— we have zero people that have been restrained in our custody, correct? We've submitted, uh, no reports within the past 3 years. So I just want to— I, I'm just trying to, like, understand how we're aggregating data around some of these things. So let's say an inmate Someone that's incarcerated, not pregnant, just someone that's incarcerated, needs medical care, leaves our— leaves DOC custody with NYPD to a hospital to receive a medical procedure?

Is that what happens when someone needs a medical procedure? No. When someone is in our care and in our custody, they remain in our custody throughout. DOC officers would be providing that escort. So in the case where I guess what I'm trying to figure out is what we understand from a case that we know of where someone was restrained or had restraints, they were technically in NYPD's custody, but they were still someone that was incarcerated, correct?

I can't speak to an individual case. I'm not sure what's being referenced, but I do, you know, if you are— if we're discussing someone who's coming in pre-arraignment, there's custody transfers that occur throughout that. Once someone has been remanded into DOC's custody, our staff are the ones that are transporting and maintaining custody of that individual. Yeah, we have in May of 2026, a woman who was 9 months pregnant gave birth in a Brooklyn courtroom.

I guess my— we have different reports on whether or not she was handcuffed during birth or post that. But I guess what I'm trying to understand is, with our data, this is a person that was in a courtroom that was technically still incarcerated under DOC custody. Why is that data point not a data point that you folks are referencing?

in your data, or is it that they're— because they're in the courtroom and they're in NYPD custody, they're technically not on your dataset? I don't know that that person was in our custody. I think generally speaking, again, when someone's remanded into our care, they come into our custody. When someone has a court appearance, there is a point of transfer when someone's going into a courtroom, at which point OCA staff may take custody, but in this specific case, I'm not aware of kind of where they were in their court and legal proceeding.

Okay. If someone's pre-arraignment, that person would not be in our custody. Right. They wouldn't come in until after arraignment. If someone is going to a court appearance and they weren't in our custody prior to going, they're not in our custody. So, if, if that person was in NYPD custody at that time, then that would be where the report would be generated from.

I guess what I'm also trying to ask is, and That makes sense. I'd love to talk offline about this specific case so I can understand the points of whether it's someone that was transferred, someone that's pre— you know, pre-detained, all these different points to get a better idea on the case itself. What I'm trying to acknowledge or infer or figure out with you folks is if and when someone is still under DOC's custody and another agency, whether that's EMS or NYPD or someone else, might be taking, you know, involved in an incident with them, whether it's in a courtroom or going to a medical facility, does that dataset still end up on your side or is it expected that it would go to the other agency?

'Cause I say this, I'm only asking 'cause there's times where we use these very specific moments as city government to kind of remove ourselves from accountability of that data point. And so that's what I'm trying to get to. Right, I think it's a point of clarity, pre-arraignment, someone is in NYPD custody. So any— Yes, that I know.

I'm just wondering, like, so, So what, what I will say is, um, right, there's state policies, state laws that govern restraints on pregnant and postpartum individuals. Um, they're overarching, but some of them are specific for certain agencies. So I think to the extent that someone is transferred into another agency's custody, they would be following their own policies in compliance with whatever laws and oversight is governing them.

Our specific policies are guided by state law and our state oversight bodies. And that's, that's why we have those policies in place. That's where the reports are getting generated from and all those timelines. And there's never a moment where someone gets transferred out of your custody and then comes back in your custody for any care, like any court date, anything like that?

It is a chain of custody that can occur when someone's given over to OCA to do the escorting with within the court parts. Right. Um, so that may be a distinction within, within reporting. Yeah. But it's, it's generally kind of associated with the staff that are handling the person in that moment. Sure. Because those, those are the policies that would be applying.

Yeah, I guess that's what I'm thinking. And that's what I— we can continue the conversation offline, but that's the point that I'm getting to is like, if we also use the datasets with the chain of custody in parallel to one another, then that might mean DOC is not necessarily logging Someone that's restrained or shackled or handcuffed for a specific reason because they are no longer technically in their custody if they're given over to another city agent.

So that is like the point that I'm trying to get to. But again, I'm happy to specifically talk about this incident and continue talking about that offline.

Did you ask? We've been joined by Councilmember Narcisse. Thank you for joining. I'll pass it over to Councilmember Narcisse for some questions. Thank you, chairs, and thank you for being here. My— I think it's around the same question that Chair has. But before I get to that, I want to see how soon after intake a pregnant woman's person seen by OB-GYN.

So the goal is to see the individual within a week's time. Within a week's time. Okay. So I'm assuming within a week time, if the person is on what trimester, the first trimester, second, because I know in the 9th trimester, that's a little more kind of like you need a GYN to see that person right away. So then the GYN, upon the completion of the intake or review, and when they get advised that there's a pregnant individual coming in, And then he, she, they will assign an appointment based on the determination of where that person is in their status of pregnancy.

Okay. Do you keep high-risk pregnant— pregnancy within the floors? How would you— how you address high risk? Because some folks are very, you know, have complications from the— So clinically indicated, we have an infirmary, and if that individual needed to live there, They can do so. But we also have partners in Elmhurst Hospital. So if that individual needed to go, they can go there as well.

That's where I work. That's part of the presentation. Yeah, I'm used to it because I used to work for Elmhurst. What happens when a pregnant person has a real high risk, right? Does it monitor like right away? So is that something part of the intake? That's what I'm trying to get in my head. Is it part of the intake process?

You are high risk, then you go to Elmhurst Hospital or you go to a clinic setup? So the intake screening will happen at whatever time the individual arrives. Then he, she, they will then get referred to the OB-GYN. The provider that's doing the screening is also clinically competent to determine what the status of that patient is and make a determination if they need to transfer that patient to us.

Again, it depends on clinical presentation. Should they need to consult with our emergency response urgent care providers that are on island, they would also do that as well to get consultation and make a determination as to what to do for the patient. Okay. So if that person from the outside had a physician that's following them, would you collaborate with that person?

Do any calls make to see what is the complexity of that pregnancy? That is always the goal, to get as much collateral information as we possibly can from our patients. So the answer is yes. Okay.

Shackling. We don't shackle pregnant women, do we? Since 2009, we passed— there's legislation that passed. Can you tell me how many women in DOC or even NYPD custody have given birth while restrained since then? Sure. Thanks for the question. Yeah, I can't speak for NYPD, but I do know that as far as DOC goes, there have been no women who have given birth while in custody who have been in any form of shackles.

Good to hear. For instance, if the person agitated, what kind of approach you take? So in the case that someone is pregnant or is 8 weeks postpartum and they're exhibiting concerning behaviors, obviously this is a challenging time and that can happen. Staff would engage in some pretty intensive de-escalation, trying to calm the individual down. There are additional staff members assigned explicitly so that restraints don't— aren't utilized, and it is really only as an absolute last resort when there is situation that arises that imminent harm can come to the person or someone else.

So at that point, it's a safety determination. Thank you. Thank you for your time. Cheers. Thank you.

Thank you so much, Councilmember Narcisse. Just a couple more questions before we move to the next panel. The city's administrative code created the doula program working group. Under law, the working group is required to meet every 6 months. Has been meeting that frequently, more frequently, less frequently? Yes, thank you for that question. We are part of the Birth Support Working Group.

We meet at least— we join the group at least twice a year, and it's been wonderful to be part of that group and get feedback and continue to work with our partners. And what have been some of the recommendations the working group has made to DOC, and have any of them been adopted? Yes, absolutely. So in their recent report, they talked about ensuring that we have a doula program, which we have a really successful doula program.

They talked about ensuring that we allow for a person to have a support person during birth, which is part of our policy and it's part of our process. So we've continued to work with the group to make sure that all the recommendations are being Is there a public place I can look at those recommendations, or are those internal?

The group has published the report, yes. Would you mind sending that over? I believe it's publicly available. Yeah, I'll look for it, but it'd be nice if you have the direct link.

And then for correctional health services, are women routinely offered the option to get a contraceptive? So yeah, at their reproductive health encounters, they would get offered. So our patients get scheduled accordingly as well. Do we offer all the options, like an IUD versus taking the pill versus the Depo shot? We do. Okay. If there's a positive test for pregnancy at a screening, is the pregnant person given the option to terminate?

Yes. Great. Are correctional officers— sorry folks, gotta ask all the questions. I heard some— are correctional officers present in the room while a pregnant patient is being examined or in the hospital during labor and delivery? No. Great. And then my last questions in case anyone else wants to think of any before we move on. Okay. What procedures are in place to ensure continuity of psychiatric care, pardon, for patients who screen positive for depression, anxiety, postpartum depression, or other perinatal mental health conditions while in custody?

Right. So part of the comprehensive medical evaluation, the nurses, medical staff are screening for mental health needs, and then they can make the referral to the mental As mentioned, we have a very low threshold for those referrals. And as mentioned in testimony, more than 80% of women in our care are enrolled in the mental health service. But referrals can be made at any point during the individual's incarceration from CHS staff, from a DOC officer, from a legal aid attorney, or other external parties.

Okay. Appreciate that.

I'm passing it over to Chair Brooks-Powers. Are medical personnel consulted before restraints are applied to a pregnant person? I think as I said previously, generally at the point, again, extremely rare, in which we are contemplating restraints, that is a safety determination that's being made, not a medical one. And so The staff that are with the person who are observing that behavior, who have not been able to restrain or calm them down by other means, would be the ones who are applying the restraints and making that determination.

Okay. Yeah, I wanted clarity on it. Thank you.

Okay, seeing no further questions, this panel is now excused. We're gonna call up the folks from Board of Corrections to join us at the dais. Thank you. Is anyone else joining you at the dais? Yes. Okay. I'm turning it over to the committee clerk to swear you folks in. Hello. Please raise your right hands. Do you affirm to tell the truth, the whole truth, and nothing but the truth before these committees and to respond honestly to councilmember questions?

Thank you. Please state your names for the record before you begin. Thank you.

Good afternoon, Chair Brooks-Powers, Chair Farias, and members of the New York City Council Committees on Criminal Justice. Justice and Women and Gender Equity. Thank you for the opportunity to provide testimony on behalf of the New York City Board of Correction regarding maternal and mental health care in city jails. I am Melissa Cinturón-Hernández, BOC's interim executive director and general counsel.

I am joined by— sorry, I am joined by Katrina Blackmon, assistant executive director of monitoring, and Chancey Augustine, director of programming and community support. Thank you, As an independent oversight body established pursuant to the New York City Charter, the Board serves as a mechanism to keep our city's jail system accountable. The Board establishes, monitors, and enforces minimum standards governing the care, custody, and safety of people detained in New York City jails.

Oversight of maternal and mental health care is a vital part of this mandate. To carry it out, The Board monitors not only compliance with its minimum standards through regular facility visits and inspections, but also identifies trends and potential areas of improvement. The Board conducts its investigations and system-wide reviews of critical issues, which encompass access to maternal and mental health care, the delivery of services, conditions of confinement, and the systems intended to support the health and well-being of people in custody.

Maternal health involves more than the delivery of a healthy child. It must ensure that every person in custody receives the services to keep them and their child healthy throughout pregnancy and postpartum. Correctional and healthcare staff must coordinate effectively and respond appropriately to maternal and mental health emergencies and ensure continuity of care. Accordingly, the Board must have access to reliable information that allows us to understand whether services are delivered as Maternal health in every phase is vital and should be regarded as a right of all individuals.

The Board has a productive partnership with the Department of Correction and Correctional Health Services on this particular topic, and we appreciate their efforts to address the needs of this population, including access to prenatal and specialized obstetric care, mental health screenings, psychiatric referrals, and individualized discharge planning. Thank you. These efforts are particularly important given the mental health challenges that can arise while incarcerated, during pregnancy, and following childbirth, including postpartum depression, anxiety, pregnancy loss, and separation from newborns.

The Board has dedicated staff who monitor facilities where people in custody are placed throughout their pregnancy and during the postpartum period. In the past, Board staff have advocated for improvements to the nursery's recreation yard, and safe and appropriate housing when the nursery was temporarily shut down for renovations. Recognizing the importance of ensuring that those housed in the nursery or receiving postpartum care are produced for scheduled court appearances, we assess how DOC maintains appropriate childcare arrangements for infants residing in the nursery.

Based on our observations of nursery operations throughout the years, the Board recommends that DOC perform a comprehensive review of its policies regarding the nursery application process to accurately reflect current correctional procedures, including the 9:00 PM lock-in time and the discontinuation of the former punitive segregation designation. The Board also handles complaints from all people in custody, troubleshooting and resolving them one-on-one.

From something as seemingly minor, but not so, as receiving a blanket, to ensuring crucial access to medical care, the Board is Guaranteeing that the board can continue this work is an essential component to maintaining the standards that are currently in place and continuing to be improved upon. For that reason, addressing maternal mental health care in the city's jails must also include strengthening the board's monitoring and research capacities.

Multiple studies performed in jail and prison settings across our country have shown that conditions of confinement for people receiving maternal care are often inconsistent and insufficient, failing to meet the healthcare needs of this population. These same studies have highlighted how children born in custody have a propensity for adverse outcomes of preterm birth, low birth weight, and stillbirth.

There are also numerous risk factors for morbidity and mortality during pregnancy and postpartum, such as a high prevalence of mental health conditions, Chronic illness, substance use disorders, and limited access to healthcare.

Accordingly, there must also be a focus on exploring alternatives to incarceration that would allow expectant mothers to receive care in their communities. Pregnancy and the postpartum period require constant access to medical supervision, mental health support, and opportunities to establish and maintain a bond between a mother and their child. Alternatives to incarceration can help reduce disruptions to care and maintain connections to their families and community-based healthcare providers.

The boards and its minimum standards of care play a key role in safeguarding access to visits and correspondence with loved ones and creating opportunities to maintain family relationships and system supports. As we continue to address the services available within correctional facilities, reducing the need for expecting and new parents to enter or remain in these settings could go a long way to preventing some of the adverse outcomes we are seeing in prisons and jails across the country.

To the extent that people in custody are in the care of the OCNCHS, the board supports a higher standard of care than would be provided outside of the jail setting, given the serious factors that are at play in this environment. This should include immediate and consistent access to mental health services, particularly postpartum, and a dormitory where people in custody could reside during their pregnancy.

Prior to the creation of the RESH Annex to house men in the Rose M. Singer Center, DOC designated a dormitory for pregnant women which allowed them to be cared for without the risks of being in general population. Those risks are made evident with cases in which certain tactics, such as releasing chemical agents or other methods of control, may need to be deployed in a housing area that would put a pregnant individual at risk.

In addition, amenities such as specialized beds, and other measures that are often used to provide better care during pregnancy are not generally available in general population. These, along with the rigors of daily jail life, can cause a cumulative effect that results in detrimental outcomes and unnecessary stress for the expectant person in custody. The board supports the council's efforts to bring greater attention to maternal health and believes this legislation provides an opportunity to build upon the ongoing work at CHS and DOC.

Officially implementing a policy for coordinated care from pregnancy through the postpartum period. In conclusion, maternal health, particularly postpartum, encompasses not just the immediacy of childbirth, but the months and sometimes years that follow. Access to appropriate medical and mental health services, opportunities to maintain contact with their children and continuity of care, as well as coordination between correctional and healthcare staff, are the pillars of maternal health that we should not only uphold but also guarantee through the policies in our correctional system in accordance with Section 306 of our standards.

The Board commends ongoing efforts by the Department, CHS, and City Council to ensure availability and access to these resources. We are committed to overseeing the implementation of these policies and reporting any concerns to the relevant agencies. the public. Thank you again for the opportunity to testify, and we welcome any questions you may have.

Thank you, and thank you for sending your testimony yesterday. I had an opportunity to read it. I appreciate the advance opportunity. Has the board ever received complaints from pregnant or postpartum people in care at the Department of Correction? Yes, we have a complaint line where people in custody can call with any issues, and we also have monitors in the facilities talking to all people in custody, all persons in custody, including people who are pregnant.

We have received concerns recently. We went out, Director Augustine went out to speak to some of the people who are currently pregnant custody, and they reported concerns about beds, about food, access to healthy food, routine access to medical and mental health care. And if there's anything else I'm missing, I can pass it over to Director Augustine. Good morning.

Good morning, Chair Brooks-Powers and Chair Farias. Yes, in speaking with with a couple of the women, they did express concerns with being housed in general population. Mm-hmm. 2 of those women, while— one while showering, the other while in her cell, were present during an incident, and a chemical agent was used. And one of those women who was in that unit, was in the shower, also suffered from asthma.

And so she expressed her concern with being in a general population house where the care and concern from the other women that she's housed with is concerning to her, where they're not generally concerned about the health of her child, but more so what's happening in the unit. Thank you for that, because as you I heard earlier, asked questions about this because I had requested that those who are pregnant be transferred into the nursery, only to hear that only one person has applied.

And so I'm curious in terms of any trends you may have identified with some of the complaints from the pregnant or postpartum individuals in custody, and also if you can kind of quantify how many of the complaints, let's say in this year, you may have received from women who are pregnant or postpartum. Good morning, everyone. Katrina Blackmon, Assistant Executive Director for the New York City Board of Correction.

So, in terms of quantifying the amount of complaints we've received from pregnant and parenting individuals in custody. That number could vary depending on the census of those pregnant and parenting in custody. But as of recent, in preparation for and even before this testimony, as Director Augustin articulated, we do routinely tour Rose M. Singer, where females and pregnant and parenting women reside.

One of the things that I can say and stress and I think one of you pointed it out, which was really helpful, is that having a dedicated housing area for pregnant and/or parenting women would be extremely beneficial because then that concentrates the focus of care for those individuals. It can allow the doula, CHS, DOC staff to readily be available to that population as opposed to, uh, I want to say, for lack of a better term, touring around and trying to identify and locate where those individuals are housed in general population.

I think having a dedicated location, it can also, without thinking too hard, you can actually know what the, uh, the quantified number is if they're all in the same location, if that makes sense. No, absolutely, because when I went to visit and I wanted to talk to one of the pregnant individuals in custody, you know, we were on a hunt to try to find them and where they were at that moment.

And I would also add the mental health benefits of being within a community of people who are going through the same thing you are. That can be extremely beneficial to these people. So we, we are really advocating for a space to be identified within Roses. It doesn't have to be the nursery, It can be its own dormitory, as it was before, for all pregnant people in custody.

And then, have you ever done an analysis as to the quality of services offered to pregnant or postpartum people in Department of Custody— Department of Correction custody? And if so, what were the results? So if we're talking about an analysis in terms Of medical care, know that there are certain limits in wanting to do that in full scale.

It would require, for example, access to information that is limited to us because of medical privacy laws. However, we do keep a close eye on those individuals. We keep a close eye on the nursery. We tour the nursery closely. Typically, we make sure that when people are out to their court appearances, that there's someone within DOC taking appropriate care of the child that is left behind.

And we receive any complaints about the nursery and address those. But I don't believe we've received any complaints about the nursery conditions themselves recently, besides the rec yard that was damaged a few years ago.

Are you folks aware of any young adults ages 18 to 21 housed in any pregnancy housing or in the nursery program? I'll pass that on to Director Augustine or AED Gladman. Yes. So to be honest, I haven't looked to see, to check the ages of the women who are pregnant within the facilities, but I wouldn't be surprised if there are women who are— who identify as being young adults and who are pregnant within the department's custody.

What I find interesting, though, is that they're— in interviewing the women, and as Chair Brooks-Powers mentioned, with having to find where these women are housed, you know, again, they're housed among general population, and the services that they're looking for, it's not necessarily as easy for them to access because they would technically have to leave the housing unit in order to get access to those services.

But yeah, to answer the question in short, not 100% sure, but it is something that we can follow up on if necessary. Yeah, I was just gonna ask, we can follow up, we can check the ages of the people who are currently pregnant in custody and follow up. helpful. I mean, I was also just going to see if the monthly census helps provide some of that data, whether that's indicating we have young adults in either the nursery program or— but if not, it would be interesting for us to kind of start looking at that and pulling that data.

Are there any recommendations for better supporting pregnant and postpartum people in custody that you folks have or Yes, the main one is the opening of the dormitory to house all pregnant people in custody. We are also advocating for the nursery application process to be reviewed. It does have outdated language, and we understand that it has to go through the necessary checks, checking criminal history, checking ACS history, but anything that can be done to make it more streamlined, be done to expedite that process and to give resources to the people who are filling them out.

We don't want people to be intimidated by the process of it, having to fill out so much paperwork. So having someone assist them would be very beneficial.

And is this a paper application or is this digital? Paper. Paper. And if I may add, Mm-hmm. The process is, as our ED shared, is not— it takes some time. In conversation with one of the women who did apply, I want to say she came into custody in July and the application was finally approved last week. And so it does take time, even though, yes, it is voluntary, but there is a process.

And there are other players within the process in order for it to get to that approval point. And do you folks have specific recommendations on how that process can either be expedited or made in layman's terms to make it more intuitive to complete? I feel like, you know, sometimes with city government generally, we have applications that We have a lot of things we have to fill out and check out for our own dataset, but they're not intuitive to, you know, a New Yorker that needs to just get through the process.

So just wondering if there are any, like, specific portions of the application where you're saying this needs to be readapted or, you know, reframed. I can start off and pass it on to A.D. Blackmon, but one of the things that comes to mind is this is a panel that's reviewing these applications. So making sure that they have strict deadlines to comply with their review would be extremely helpful.

And I'll pass it on to A.D. Blackmon for any other details. Thank you. Yes. So when it comes to the application process, I want to say that first and foremost, that it should absolutely be updated and reflective of today's information and language. And it should also— to ED Cintron-Hernandez's statement that the interdisciplinary panel should be readily identified.

Right now, part of the application process in terms of the language is outdated, and it speaks to the Deputy Warden of Programs. But as we know right now, and tell me if I'm wrong, Director Augustin, there's now the Executive Director of Programs that's at every facility. So that's part of it. And then when you review the application itself, the nursery application, I think some of the questions are a bit redundant, especially the part about ACS in terms of who lives outside of the home, how many children you have.

And while all that information is important and relevant, I think maybe just having that question once during the application process anywhere in the application process is fine, as opposed to reviewing it or having to write it down a couple of times, because we also have to be mindful of literacy. Sure. We also have to be mindful of language.

English as a second language is also a thing. Even though that the department has a very robust language bank, some of this information might be a little bit exhausting when you have to write it out multiple times. If you've ever been to the DMV, you know what I'm talking about. Yeah. Is— and is this application in multiple languages?

Do you know? From what I could see, the application— I've seen the application in English and in Spanish. Those are the 2 languages I've seen it in before. And I just want to highlight that our minimum standards 1-01 requires that any communications of any significant matter provided to people in custody be in their preferred language, particularly if it's Spanish.

Yeah, that's, that's why I was asking. Just wondering if we have a generated translated version in at least the 5 set, the top 7 I think we have as a city, but We can find that out after the hearing.

Just my last question. The board's rules require that clothing be provided to people in custody, but does not explicitly mention children who may be living within the— with the incarcerated parent as part of the nursery program. Do you think the rules adequately cover the necessary infant clothing and materials needed for the children that are with their parent I can confirm that the rules don't go into that.

I think there's definitely space to include that information, particularly in our Chapter 3 where we speak about pregnancy and postpartum care to ensure that any children who are in custody do have adequate clothing. So that is definitely a gap in our minimum standards that should be addressed.

Okay. Thank you for that. I don't have any additional questions, Chair. Just a follow-up. What data does the board receive on pregnant and postpartum people? I'll pass it on to AED Blackman, but I do believe we receive a list of current— of people who are currently in custody who are pregnant. And what information would be useful for your oversight function as it pertains to pregnant and postpartum folks in custody?

So on the DOC side, while we currently have, it's useful in terms of being able to identify where the person is so we can go speak to that individual. On the medical side, because of, again, the limitations that we have to medical information due to medical privacy laws, if we want to do a whole-scale review of the kind of medical care that is given to this population, we will be limited in that.

If we want to To do one-on-one evaluations with the individuals that are currently in care, we would rely on consent. So that would certainly be of help to the board. We— our access to medical information is governed by the public health law and the mental hygiene law. There is currently a provision that allows us to have access to medical records of those who have died in custody.

Expanding that, advocating to the state legislature to expand that access. access to encompass other types of medical information, particularly for vulnerable populations, will be extremely helpful.

I'd like to acknowledge we've been joined by Councilmember Aldabal as well, but seeing no additional questions— oh, you do, Councilmember Narcisse? As now, how many pregnant women in custody right now do you So there are 5 women who are either pregnant or receiving postpartum care, plus 1 mother and 1 child in the nursery. Okay. So how many of them gave birth actually under— while they're in custody last year?

I'm not familiar with that. I'll pass it over to Director Augustin to see if he has the information, and if not, we will certainly follow up with an answer. Okay, and go ahead, go ahead. No, you can answer and I'll ask the question. Yeah, thank you. So, uh, we don't have that, that information, um, but again, as, um, our ED, um, shared, we can absolutely get it if, uh, if necessary.

Okay, and I will add that the person who is in the nursery right now, I believe, gave birth earlier this year, not last year. Okay. And also, I don't know if you're counting stillbirth as well, because we do— we did have, in conversation with the women in the facility, one did divulge to me that she did experience having a stillbirth.

Mm-hmm. Yeah, and so that, to add to that, when I asked her if she had had access to mental health support, she said she hadn't. met with mental health, um, anyone from a clinician or any, uh, mental health professional since that experience. Okay, thank you. And I'm going to ask you about the restraint as well. How many women give birth that you know of, um, while restraining, for whatever the reason?

It may be agitation, it may be something else. Thank you for the question. So far, to the board's knowledge, We have not encountered or have there been any reports of women in custody who are pregnant or giving birth who are restrained during labor or delivery. Thank you. When a woman goes into labor at Rose Sanger, how long does it take from the time they're in labor to get to a hospital?

In terms of the time it takes, that's something we will have to follow up on with CHS. That's information that they have, and we would need to receive consent from the person in custody to be able to access that particular information. But as we've heard earlier from CHS, the mother— the person is transported to Elmhurst Hospital to give birth.

I do just want to clarify for Councilmember Narcisse. we are in front of the Board of Correction. We can take some of these questions. I know, I know. I'm getting to it. I know very well. We can take them directly to OCHS and DOC. I got you. I got you. But the reason I'm saying, because they're there to work, because in the statement you made, you work very closely.

So I'm assuming that you know you have a great partnership and those are the important steps because what I'm leading to as being a nurse, is because the time that you take from that person to have labor, if we're not addressing it, it becomes complex. You can lose a baby. So that's where I'm going with you, Madam Chair.

So that's where— so if it's complex, if it's complex, you can lose that baby during the process. Because I deal with high-risk pregnancy and I know the importance of it when the time the person in labor and what are the steps, the paperwork before you can get that person to a hospital. So I'm leaving it as that.

So thank you. So just observe for that because that can be a complication. Thank you.

Thank you, folks. We've been joined by Councilmember Gutierrez as well. And for this panel, I don't see any additional questions. We'll follow up with Department of Corrections and CHS on the questions from any of the colleagues on the panel so they can get the appropriate answer. with the right contacts. You folks don't need to follow up on that.

This panel is now excused. Thank you so much for your time today. Thank you. We're now going to head and open the hearing up for public testimony. I remind members of the public that this is a government proceeding and that decorum shall be observed at all times. Members of the public shall remain silent unless called upon to testify.

All testimony testimony must be relevant to today's hearing on maternal health and criminal justice. If remarks stray from the subject matter, speakers will be reminded of the topic and asked to refocus their comments by me as chair. The witness table is reserved for people who wish to testify. No video recording or photography is allowed from the witness table.

Further, members of the public may not present audio or video recordings as testimony but may submit transcripts of such recordings to the Sergeant-at-Arms for inclusion in the hearing. If you wish to speak at today's hearing, please fill out an appearance slip at the Sergeant-at-Arms desk and wait to be recognized. When recognized, you will have 2 minutes to speak on today's oversight topic and/or legislation.

If you have a written statement or additional written testimony you wish to submit for the record, please provide a copy of that testimony to the Sergeant-at-Arms. You may also email your written testimony testimony to testimony@council.nyc.gov within 72 hours of this hearing. Audio and video recordings, again, will not be accepted. As a reminder to all of our witnesses, please state your name prior to your testimony for the record.

If anyone here today requires an accessible version of the presentation given at today's hearing, please email testimony@council.nyc.gov. And I will now call the first panel. Isabel Seda. Jillian Modzelewski. Rachel Bronstein. Hannah, you may begin when ready.

Good afternoon. Thank you, Chairs Farias and Brooks Powers, and all members of the committees for holding this hearing today. I am providing this testimony on behalf of Brooklyn Borough President Antonio Reynoso. My name is Hannah Mae Powers, and I'm the office's health and safety policy analyst. Our office supports Intro 902 and the companion resolutions 464 and 9— sorry, 498, which aim to provide more standardized and compassionate mental health care and processing for perinatal women.

Maternal mental health disorders are remarkably common, affecting approximately 1 in every 5 perinatal women. Maternal mental health conditions such as perinatal mood and anxiety and substance use disorders are also leading contributing to pregnancy-associated deaths, both nationally and locally. However, these disorders are not readily identified or adequately treated. We also know that mental health disorders, including substance use disorders, are overrepresented among those involved in the criminal legal system.

This holds true for women of reproductive age in the carceral population, with one study showing that 43% of them meet the lifetime criteria for serious mental illness. 53% meet the lifetime criteria for PTSD, and 82% meet the criteria for substance use disorder. Preexisting mental health disorders also may precipitate involvement in the carceral system, especially for women. According to the Women's Center for Justice, over 80% of women in New York City jails have mental health concerns.

Unfortunately, Rikers functions as the largest mental health provider in the city and detain persons with mental health concerns are implicated in an inhumane system that was not built to provide care. We ask the council to reaffirm its commitment to providing comprehensive and compassionate healthcare to all New Yorkers by passing the legislation and resolutions on today's agenda. This will facilitate needed mental health treatment and allow reasonable considerations to be made in the criminal prosecution sentencing of perinatal and postpartum women in the Crossroads system.

Thank you again for the opportunity. Thank you. to testify today.

We can just go down the line. Good afternoon, Chair Farias and Chair Brooks-Powers and the members of the committee. My name is Rachel Bronstein. I'm the senior director of policy at Her Justice. For more than 30 years, Her Justice has partnered with women and gender-diverse New Yorkers living in poverty to address family, matrimonial, and immigration legal needs.

Through our pro bono-first model, recruiting and mentoring the city's premier law firms to represent our clients, we see firsthand how gender-based violence affects economic stability, health, and safety. Her Justice supports Intro 1144 and appreciates the council's commitment to strengthening the city's understanding of gender-based violence through better data collection and reporting. Our primary recommendation is that the city take an expansive view of what constitutes gender-based violence data.

Law enforcement data is important, but it captures only part of the picture. Many survivors, particularly immigrants and others who may distrust or fear interaction with the criminal legal system, do not report abuse to law enforcement. To understand the true scope of need, the city should incorporate data from service providers that work directly with survivors every day and the legal systems which we work.

Legal service providers have valuable insight into the challenges survivors face and the support they need. Our own data demonstrates that legal services can advance economic security and well-being. For example, securing child support can provide critical financial stability for families leaving abuse, and our research has shown that obtaining a work authorization improves immigrant survivors' health and stability. We also encourage the city to collect and analyze data regarding Survivors seeking divorce.

As the council moves forward with efforts to expand access to divorce representation for domestic violence survivors through Intro 1175, there is an important opportunity to address the significant data gap around domestic violence in divorce proceedings. Better court data would help policymakers assess need, evaluate services, and inform future investments. Thank you for your leadership and the opportunity to testify.

Good afternoon. My name is Jillian Modzelewski, and I'm the director of the Women's Defense Project at Brooklyn Defender Services. Thank you to Chairs Brooks, Powers, and Farias for inviting us to testify today about maternal health in the criminal legal system. Brooklyn Defender Services is a public defense office representing about 40,000 people in Brooklyn and Queens each year.

I helped launch the BDS Women's Defense Project in 2020 after years of representing criminalized trafficking victims in the Human Trafficking Intervention Court. Our interdisciplinary team of attorneys and social workers serve cisgender and transgender women who have experienced a history of violence, exploitation, and abuse that has directly or indirectly led to their involvement in the criminal legal system.

In my practice, I have represented people who are pregnant, postpartum, parenting, and experiencing pregnancy loss, all while navigating the criminal legal system. The vast majority of women with criminal legal system involvement have experienced violence or trauma in their lives prior to incarceration. Foremost, no one should be forced to labor or give birth behind bars, in restraints, or in a courtroom.

For New York to continue to subject people to these conditions is a devastating reflection of cruelty embedded in our carceral system. All people in the criminal legal system deserve to be treated with care, compassion, and dignity. We strongly support Resolution 497 and are grateful that the State Senate and Assembly passed this critical legislation. I'm looking at my time, and one point I do want raise before my time is up is access to care.

Most of my clients have experienced some sort of sexual assault or violence, and that really prevents them from accessing care. Gynecological exams can be very intimidating for those people, so it's important that the care that is provided for them in Rikers is trauma-informed around that point. Thank you for your time.

Good afternoon. My name is Isabella Seda, and I am the social justice community organizer at New Hour. We are deeply grateful for New York City's council members to address the impact of pregnancy on individuals in New York City's criminal legal system. New Hour is a nonprofit dedicated to empowering justice-impacted women and families across states. We provide direct service to incarcerated, detained, pregnant, and postpartum individuals in New York and advocate for policy reforms.

We assent to the passage of Resolution 497, which would urge Governor Hochul to sign the anti-shackling bill into law. We ask that no chapter amendments are made. The experience of a mother who gave birth in shackles in a Brooklyn courtroom earlier this year and the injustice she endured has brought attention to the issue, but we recognize that this isn't a unique experience.

Overwhelmingly, women are detained and pregnant and are constantly neglected and abused. Resolution 498 addresses the postponement to court proceedings for women in late-term pregnancy and early postpartum. We have been able to see pregnant women subjected to lengthy waiting in holding cells. They should be able to appear in court without spending an often full day waiting in freezing cold cells.

New York currently postpones court proceedings due to severe illness and medical injury, but not for pregnancy. The same are virtual court options must be prioritized. We ask for the broader expansion of the approved diagnosis on postpartum on Resolution 464. Postpartum psychosis is one of the many possible mental health challenges individuals face after birth. Perinatal mood and anxiety disorders include a range of mental health conditions.

For those already sentenced, they must have the right to file a request for an alternative sentencing hearing. Lastly, with reference to Intro 902, we believe that data collection is necessary. However, NEWOUR has witnessed data weaponized against parents in family court proceedings and custody proceedings. We acknowledge Intro Resolution 902 is an attempt to ensure transparency. However, health protocols should be established and maintained by healthcare professionals, not the Department of Corrections.

We ask that City Council approach— thank you. You can finish. Okay. We ask that City Council approach legislation related to maternal health and incarceration with understanding of the challenges people face rather than create levers of long-lasting negative impact on families often already overpoliced and targeted by misguided legislation. Thank you for your time.

Thank you so much. Recognizing Councilmember Gutierrez. Thank you. I had one question. You had mentioned at the end about trauma-informed care, and I thank you for raising that. Obviously, it's a lot of what we advocate for here, but considering the circumstances that Rosie is It's a little different. What is the— what's the landscape now for gynecological care?

Like, what— how are medical professionals getting trauma-informed training? Or, yeah, what is happening now with that lens? So I believe there is 1 or 2 clinics within New York City that is dedicated or has trained professionals around that trauma-informed care for women who've experienced sexual violence. I believe there's only one gynecologist on Rikers Island. I'm not sure if they are trained around that.

But a lot of my clients do say they are fearful to go to gynecological exams because of what they've experienced. So allowing them to to pick their own medical provider, you know, look around for medical providers that know what it's like to be a survivor of sexual violence would be incredibly helpful. And requiring providers to go through some sort of trauma-informed training around examining women who have experienced sexual violence.

Thank you so much.

This panel is now excused. I'd like to call the next panel. Zedaya Amafohl Matan, Khalil Tucker, Liz Swivola, Olivia Picard. Apologies on mis— any mispronunciations as I'm reading from the appearance cards. Good afternoon. Sergeant, there's testimony that has to be grabbed. Sergeant. And— You can begin when ready.

Good morning, Chairs Farias and Brooks-Powers, and thank you, council members, for the opportunity to speak. My name is Olivia Pickard. I am a staff attorney on the VOLES Incarcerated Mothers Law Project. VOLES supports New Yorkers with comprehensive free legal advice, education, and representation. For over 40 years, VOLES has partnered with community-based organizations to provide free civil legal services to New Yorkers who otherwise would not have access to that.

For more than 30 years, VOLES Incarcerated Mothers Law Project has helped individuals in New York's women's prisons and jails, including the Rose M. Singer Center on Rikers Island, with their family law needs. Through this work, VOLES IMLP has provided legal support and advocacy to numerous pregnant and postpartum individuals in New York's prisons and jails. Our pregnant and postpartum clients in jail or prison are at a uniquely vulnerable stage of their life, both medically and legally.

Parents often come to us with severe anxieties about the state of their parental rights. This is especially true for postpartum clients who may be separated from their newborn child soon after giving birth and do not know what to do next to strengthen or to preserve their parental rights. Many individuals in custody have experienced foster care themselves and are terrified of CPS, DSS, or ACS involvement.

In one case, a VOLES IMLP client was separated from her newborn child immediately after birth by New York County DSS. She was asked to sign parental authority away hours after giving birth without ever having spoken to a lawyer. But perhaps the most visible issue is the toll on mental health of being pregnant, giving birth, and being postpartum while in state custody.

Being pregnant or postpartum while in prison or jail can exacerbate existing mental health issues and often require specific and targeted mental health interventions. Our pregnant and postpartum clients have expressed feeling dehumanized and traumatized by their experience of birth while in custody, custody during a time where they already feel at risk of losing hope. Therefore, VOLS/IMLP strongly supports Councilmember Lee's proposed local law to amend the administrative code regarding mental health protocols for pregnant and postpartum individuals in the custody of DOC.

Thank you.

Good afternoon. I'm Liz Suavola, Chief Impact Officer at the Women's Prison Association. Thank you for the opportunity to testify. For more than 180 years, WPA has served women impacted by incarceration. We provide a continuum of care with women in the community, at Rikers Island and Bedford Hills, and as they transition home. Our work includes case management, alternatives to incarceration and pretrial detention, reentry, housing, and trauma-responsive clinical care.

We appreciate the urgent need to address maternal mental health for people in DOC. custody. Pregnancy and the postpartum period are challenging and vulnerable times full of uncertainty and physical and emotional demands, all of which are exacerbated by incarceration and the trauma it inflicts. WPA agrees that no person should be shackled while pregnant or postpartum, and that postpartum mental health struggles should be a mitigating factor.

We hope to see these pieces of legislation pass immediately. At the same time, We urge council members to work diligently to reduce the footprint of incarceration and close the Rose M. Singer Center, the jail for women at Rikers. It costs a staggering $500,000 to incarcerate someone at Rikers. Instead, those funds should be invested in helping women heal and thrive through community-based care and support.

Incarceration is not inevitable. There are better pathways for women enmeshed in the criminal legal system, including those who are pregnant and postpartum. Incarcerated women are more likely to have histories of trauma, abuse, and mental health challenges that require access to treatment and care tailored to their unique needs. Research also shows that pregnant people often come into the system with experiences that can increase complications and adverse outcomes, such as poverty, being unhoused, chronic health conditions, and substance use disorders.

Jails and prisons are not equipped or designed to provide the necessary level of care. The number of women incarcerated at Rikers recently surpassed 500, nearly double what it was 5 years ago. While the number of men is decreasing, we are moving backwards when it comes to women. Thank you. Thank you.

Thank you, Councilmember Selvina N. Brooks-Powers, and Councilmember Amanda Farivas for holding this joint hearing on the maternal health of the women detained in New York City jails. My name is Ziada Amatou-Mateen, and I am a member of the Cortelle Center for Equity, Health, and Justice. As someone who has had family members incarcerated at Rikers Island, I know firsthand how dire the conditions Are there.

Every minute that passes by is another minute that the people detained there run the risk of losing their lives. We submit this testimony to bring your attention, attention to the ever-growing crisis at Rikers and the need to reduce the city jail's population and shutter the notorious and deadly jail complex. We are grateful to the council for introducing legislation that will require the Department of Correction in coordination with Correctional Health Services to establish and maintain written protocol related to the identification, screening, referral, monitoring, and follow-up care of pregnant or postpartum individuals with mental health needs.

As a mother myself, I can confirm that pregnancy, postpartum recovery, and parenting do not Stop at a jail gate. And it is infuriating to know that women detained at Rikers are met with a system that fails to provide them with the wraparound services that they need to endure, the health and that of their babies. This system is perpetuating general trauma.

I want to be clear that no city that is serious about reversing maternal mortality Particularly the daily racial disparities that we face as Black women, can continue to cage women on an island with a deep history of abuse and medical neglect. The care they need is not getting delivered. What is being done is simply putting a bandage on a wound that is far too deep and must be aggressively treated.

In this case, what the women need is an immediate, immediate Closure of the Rikers Island jail complex, including the Rose M. Singer Center. These women should be in the community getting the care and support they deserve. We urge these 2 committees and the full council to use their legislative power to reduce the jail population, advance the closure of Rikers with a clear timeline, and hold the mayor accountable to the closure law.

Lives are at stake.

Thank you for this testimony. Good afternoon, committee. My name is Michael Tucker, not Khalil's. I just want to clarify that. I'm an organization— I'm part of an organization called the Community Hub and was invited to be a part of this as partner with the Khalil's Cartel Center. In June, on June 10th, as well as June 25th, I spoke at the New York City Council of Criminal Justice hearings representing a family who has a member on Rikers Island that's been there to date 3,000 days.

I'm here today because at both of those hearings, I urged the committee to do a few things. One, do a full audit of Department of Corrections as well as CHS. I ask that their funding be froze. I'm asking to have an immediate, immediate hearing, if possible, at Rikers Island, because we are hearing from the people that work there and come here to tell us what is going on.

When you ask them questions, they can't fully answer those questions. I would love to see this committee hold this hearing. at Rikers Island to speak to the inmates, to the individuals that's there suffering every day, dealing with mental health issues, dealing with being abused by the correction officers and the people that are there in place to protect— not to protect them, but to basically make sure that they're doing what they're supposed to do in regards to doing their time.

Millions of dollars are being spent with these agencies and they're doing nothing. Once again, I'm asking that y'all have a hearing, subpoena the department, Stanley Richardson, have him come back and testify, the head of CHS, because it is critical that Rikers Island is closed, not tomorrow, today. And people are tired of their family members suffering at Rikers Island.

And as I said, this is what y'all are here for. And we are asking y'all to hold them accountable. People are not being held accountable.

Thank you for your testimony. And actually, just for the record, I have requested to have a hearing on Rikers Island. Unfortunately, it has not been approved, but we continue to try to advocate for it because there are a lot of layers in terms of facilitating a hearing on Rikers Island in terms of safety, security, and technology as well.

But thank you for your— all of your testimony.

Thank you. I see no questions. This panel is now excused. I will call the last panel up for Christopher Johnson. Counsel, do we have any virtual Seeing no virtual testimony, calling one more time for Christopher Johnson in the room. With that, this hearing is now adjourned. Thank you.