The Illinois State Bar Association’s Director of Legislative Affairs, James Covington, joined the Standing Committee on Women and the Law for our August meeting, at which he discussed with us several pending bills. One bill in particular, House Bill 1958, aroused many members’ curiosity. Illinois State Representative, Robyn Gabel is the sponsor of this bill.
Robyn Gabel has served as the Executive Director of the Illinois Maternal and Child Health Coalition for 20 years. As the Executive Director, she is responsible for carrying out the Coalition’s mission of improving the health of women and children in Illinois through policy development, education and advocacy.
She began her career as an educator in a women’s health center, later serving as the training coordinator and eventually co-director of other health centers. As her interest in public service increased, Gabel became a legislative assistant to then-Alderman Luis Gutierrez in Chicago, where she was responsible for the development of policy positions and legislation for healthcare, housing and economic development.
State Representative Gabel has received numerous awards for her work for Illinois families, including the Grace Today Magazine, Women’s Health Activism Award (2007); Illinois Public Health Association, President’s Award (1998); Infant Welfare Society, Child Advocate Award (1998). She is a member of the Delta Omega Honorary Public Health Society.
The following is a brief summary of House Bill 1958:
Provides that a county department of corrections and the Illinois Department of Corrections shall not apply security restraints to a prisoner that has been determined by a qualified medical professional to be pregnant and is known by the county department of corrections or the Illinois Department of Corrections to be pregnant or in postpartum recovery, unless the corrections official makes an individualized determination that the prisoner presents a substantial flight risk or some other extraordinary circumstance that dictates security restraints be used to ensure the safety and security of the prisoner, her child or unborn child, the staff of the Illinois Department of Corrections, a county department of corrections, or the medical facility, other prisoners, or the public. Provides that leg irons, shackles, or waist shackles shall not be used on any pregnant or postpartum prisoner regardless of security classification. Amends the Local Governmental and Governmental Employees Tort Immunity Act. Provides that the county department of corrections official is immune from civil liability when applying security restraints to pregnant prisoners or those in postpartum recovery, except for willful and wanton conduct.
I contacted State Representative Gabel after our August Committee meeting and she graciously agreed to an interview with me in October at her offices in Evanston.
MP: Thank you very much on behalf of the ISBA Standing Committee on Woman and the Law for taking time with me today to talk about House Bill 1958. My first question to you was going to be why in the world do you have an interest in this, but having looked at your very impressive background and your interest in women’s and children’s health, I can understand the genesis of that interest. I would like you to tell me just how you became interested in House Bill 1958 and why you decided to sponsor it.
RG: Before I became a State Representative, I was Executive Director of the Illinois Maternal and Child Health Coalition for 22 years and as the Director of that organization we did primarily policy and advocacy work. Actually, this issue was one of the issues that was supported when I was the Director of the Coalition. So when I became a State Representative, many of the groups who worked with us on some of the health issues for woman and children then approached me to see if I would be interested in carrying the Bill the next time. I was. It was an issue that we had looked at previously that I was concerned about in my last job, so it just made sense that once I became the State Representative, I would be interested in moving this issue forward.
MP: How actually did this Bill come to be? Was there a particular case, did a woman file a lawsuit in which she was shackled as a prisoner or a pregnant prisoner?
RG: The way it came to me is that CLAIM approached me to see if I would carry the Bill. They had it pretty much worked out and had spent quite a bit of time with the Cook County Sheriff’s Office in order to work out a bill that they could all agree on. They gave me the Bill. I believe there were a couple of woman who had approached CLAIM.
MP: What is CLAIM?
RG: CLAIM stands for “Chicago Legal Advocacy for Incarcerated Mothers.” It provides legal and educational services to maintain the bond between imprisoned mothers and their children. It also advocates for policies and programs that benefit families of imprisoned mothers and reduce incarceration of women and girls. The ACLU is working with CLAIM as well. There was a woman who experienced being shackled during labor and she had a lot of post-traumatic stress from that experience. So they prepared this Bill and asked me to carry it. They had originally made this agreement with the Cook County Sheriff’s Office, Tom Dart’s Office and then they made the Bill actually be effective for the entire State of Illinois. We presented this Bill in Committee and the Department of Corrections came and testified against it.
MP: Do you know who specifically testified against it?
RG: Jenny Shack.
MP: What was her opposition to it?
RG: She said that there were two issues that were of a concern to us. One was that we didn’t want a guard inside the room when the woman was in labor. Women had said that the guards would sit there and watch television and eat pizza and cheer for their teams while the woman was in labor. Being in labor is a very intense personal experience and to have to share that with a male stranger in the room with you is very traumatic. We wanted a guard to be outside the room. That was what the original 1999 law said. There was a law passed in 1999 that stated that a guard should be outside the room. What it didn’t say was that a guard could not be in the room. So people interpreted the law the way they wanted to. They objected to that. The Department of Corrections said, “What happens if the woman has a weapon and attacks the doctors or tries to jump out the window if there wasn’t a guard in the room?”
We said that the guard needs to go in initially when the woman is in the room in order to check the room and make sure there is nothing in there that is dangerous and that there is no window the woman can jump out of and if all that is safe, then there is no reason for a guard to stay in the room, unless the woman wants the guard to do so. There have been instances where there may be a female guard and, if the prisoner wants the female guard in the room, with her then that is fine. But it should be up to the prisoner to decide if she wants to be alone or if she wants to have the guard with her. They decided that wasn’t good enough. They just kept harping on the idea that there was something in the room that the woman could use to cause harm to someone.
We modified the Bill to say that if the doctor(s) felt that this woman was a danger, the doctor(s) could ask the guard to be in the room with them when they were in the room. Still wasn’t good enough. The other issue was the shackling of the pregnant prisoner. The original Bill I think said “shackling during labor.” There were other issues concerning the danger of shackling legs and hands when the woman is big, because her center of gravity is shifted, which makes it is easy for her to fall. If she falls, she can’t protect herself by putting her hands out. There is absolutely no reason for a belly shackle on a pregnant woman, period, ever, the end.
They said that there were many times when a woman may have to be taken out to the doctor or taken out for different visits where it was important that she be shackled in some way. We finally agreed to no leg shackles, but hand shackles had to be a little distance apart so the woman, if she fell, could catch herself, at least. We compromised on that. It still wasn’t good enough.
MP: Who testified on behalf of the Bill? Did you have experts come in and testify?
RG: We did. We had Gail Smith, who is the Executive Director of CLAIM and, I believe, we had a prisoner herself to be there to testify. I do not believe she had an opportunity to do so. If you have ever been in Committee, you know all witnesses aren’t always called.
MP: Was she a woman who had been shackled?
MP: Did you call doctors to testify?
RG: I don’t believe so, but we do have doctors who support us on this. We did have them write letters for us particularly, Dr. Liz Feldman. There were some other doctors as well.
MP: Have you had any community feedback? Any citizen feedback? Anybody talking about it?
RG: I have gone around and talked about the Bill to various groups in the 18th District. I have gotten support for the issue.
MP: Geographically, what does the 18th District encompass?
RG: Currently it has a little of Rogers Park, Evanston, part of Wilmette, Winnetka. That is where it is right now. In the re-districting, it will include Glencoe, Northbrook, Northfield.
MP: In your opinion, is that a more open-minded a more liberal district than, let’s say, rural Illinois?
RG: Undoubtedly. This District is still primarily Democrat. What I found is that many of the people are doing well here and that they have very generous hearts.
MP: What is your hope for the Bill? How do you feel about its passing?
RG: We have spent the summer trying to negotiate with the Department. It’s really the Department that is holding this back.
MP: Meaning, IDOC?
RG: Yes, the Illinois Department of Corrections. We have the Governor’s office involved. We feel that with Pat Quinn as Governor, there is no reason that his department should be against this. It is unheard of. We have his staff involved. We have provided research with them around other States. They seem to be supportive.
I went with Representative Lisa Hernandez and Senator Heather Steans to the women’s prison in Dwight to interview people. So I have two more supporters, strong supporters, in the legislature as well. There were about three or four other legislators that wanted to come but couldn’t make it.
We interviewed six or seven or the woman prisoners there, to see what their experience has been. Interestingly enough, some of them had said they were shackled with legs and hands in other small counties, like LaSalle County and other counties, which is one of the reasons why we want to pass a broader Bill to affect all of Illinois.
RG: And during our visit to Dwight we asked the women about mental illness. On first interviews that about 50% of the woman said they had mental illness but after awhile when they felt more comfortable with the staff, it’s over, 90%. A lot of them are there for prostitution, drugs, petty theft. Some of them are getting treatment, they do see counselors, and they do see substance abuse counselors.
It was interesting, they were telling us how the women make birthday cakes for each other, by purchasing Twinkies and putting them together. They figure out ways to cook. Many of the pregnant women told us that they are hungry all the time. We asked the staff if they get an increase in their food and they said that they do not if their doctor doesn’t prescribe it or decided they get enough calories.
MP: Is there a bill in the making there, do you think?
RG: I’m always a big advocate of trying to do things administratively before you try to pass a law. Sometimes you can just get it done.
What happens is that some women who get extra money from home or earn extra money there they buy a lot of food at the commissary. They buy tons of food, packaged food, packaged meat, and packaged everything. One of the pregnant women said to me, “I don’t have any money, so I can’t buy any extra food.”
The women don’t look thin there because I think they eat all the extra food that they can afford to buy. I asked them what they ate. They gave me what they got for that day for breakfast, lunch and dinner. It did not seem like enough protein for them; certainly not enough calcium. They said if one particular woman was on duty, she let them take two milks, but the other people didn’t let them take two milks.
MP: Do they give them prenatal supplements?
RG: I don’t know that.
MP: With your background and your history, what other bills have you sponsored or been an active part of that relate to women?
RG: I have passed six bills out of the House in my first term, which is very exciting. Many of them center around woman and children’s healthcare. One of them one concerned immunization. We have an immunization registry in Illinois and, before my Bill, it was an opt-in registry so everybody had to sign a form at their pediatrician’s office to say that they wanted their children’s immunization records put into a registry. We changed that to an opt-out so that the doctors would be able to put everybody’s immunizations information in without having to have those forms signed. There will be a form available if parents do not want their information included.
It is a great thing to have. People move so often and you can lose those little pieces of paper that the doctor gives you with your children’s immunization record on them. It is wonderful that parents can get the information through this registry and that schools can get it through the registry. Because children need the immunizations before they go to school.
There was a study done in Englewood in which they were drawing blood for lead poisoning. So they also decided to see what the numbers were for immunization for measles and mumps for the MMR vaccine. We thought that children in Englewood were about 50% immunized and when we got back the blood results, we found that 98% had been immunized.
So what that means is that children, because they didn’t have the records were being immunized multiple times for the same disease because they didn’t know if they had received the shot. This way, if we have records, then it will be easier to keep track of that. That is one bill I passed. Another bill relating to children’s health was given to me by the Health and Disability Advocates. There is a law that says, “children who are sick for a number of days out of school or are going to be intermittently absent from school, such as if they have cancer and need treatment every other week, the school has to provide home or hospital instruction for them.”
The parents were having a very difficult time getting this home instruction. So I passed a bill that said it had to be provided within five days of a doctor’s note, it also defined what intermittent care was. It was if a doctor sent a note and said this child will be having intermittent treatment and needs to have care. People were very excited that they at least had a law that said after five days, they had to get someone to educate these kids. They had been going months without education. That was a second bill I passed.
Another bill that I carried that did not pass was for certified professional mid-wives. Twenty-two other States have a separate license for certified professional mid-wives. There is a particular training that they have to do, that is very comparable to what nurse mid-wives go through. They do as many deliveries as a med student would do in a rotation and they are trained very specifically for home births. Because right now, doctors are not really providing home birth, they are doing home visits; they are not doing home birth. Nurse mid-wives cannot do home births without a doctor. So if a doctor won’t do them, nurse mid-wives can’t do them. There are about 800 women who want home births every year. It’s not unheard; there are some women who belong to certain religious groups who want them for religious reasons.
There were doctors doing them. Dr. Einstein was doing them, there were other doctors who were but they have all kind of, the malpractice insurance has gone so sky rocket high, that they can’t do them anymore.
RG: That bill had been in the legislature for ten years. My predecessor, Julie Hamos, had been the sponsor of the bill. So when I came in for the end of session in 2010, I picked up the bill. The first week I was there I was actually able to get the bill out of Committee. They had never gotten it out of Committee before! We were very excited. It was on the floor. We were all working as very hard, the medical society was absolutely against it. It was one of the major bills they were against.
MP: What was their reason?
RG: “It’s not safe.”
MP: Because it was a mid-wife and not a doctor.
RG: “It’s not safe to do a home birth.” Clearly, they are just protecting their turf, which is ridiculous because ob/gyn is a surgical field. In other countries, for instance in England, 80% of births are done by mid-wives.
Right now what we call it is “Home Birth Safety Act” because right now these 800 women who want to have home births, are using mid-wives whom we do not know if they are certified or we don’t know if they are trained. We don’t know what their training is. We feel that it would be much better to actually have a licensure and have them trained so that we know they are capable of assisting in the home birth. Also, in that way, you could have a plan in place if something goes wrong to make sure that these women safely get to the hospital.
There have been numerous stories of women who had a home birth, who tore a little too much and they needed to go to the hospital to get stitched up. The doctors in the emergency room spent more time harassing them about why did they dare to have a home birth, who is their mid-wife, they better tell them who it was, yelling at them, screaming at them and then sewing them up. I heard of one case in which they actually called DCFS on this couple for having a home birth and the baby was taken away from them for a period of time. Simply for having a home birth, which really doesn’t make much sense.
MP: Absolutely not. What is the future of that bill?
RG: I knew we didn’t have the votes, but the mid-wives really wanted me to call the bill. We called it. I think we had about 47 or 48 votes on it. We need 60. The next year we tried putting in a bill that was just going to provide a way for women to go to the hospital to be treated well and safely. The hospital association worked with us on the bill and there was very little support. The medical society again was against the safe transfer of women to the hospital. It’s absurd. There were so many other issues going on that it didn’t make sense to try and move that bill forward, so we said that we might as well wait until next year and just do another home birth safety act and see if we can move it forward this time. Maybe the medical society will get involved in other issues and won’t have as much time to fight this one.
RG: There are new people coming in and it’s funny but some of the Tea Party members really like this bill.
RG: I have some strong Republican support on this. They believe in personal freedoms, so there is some support from them.
MP: That is very interesting that you have a little pocket of that kind of support. What other bills, have you sponsored relating to woman?
RG: Those are the ones that I can think of right off the top.
MP: Kid Care, were you a part of that or All Kids?
RG: I was, yes. I was very active in advocating for those changes in health insurance for children. Actually, when we first started, about 800,000 women and families and children had health insurance through the State. When I left 2 ½ million did. RG: So we increased the ranks tremendously and we also did a study to show that when the kids received Kid Care and All Kids, the children were able to actually see the doctor. Whereas, before they had not been able to do so. It is really wonderful. We know that health insurance is the first step and then access to doctors is the second. We proved that they were able to get it with their cards. Kids who don’t have insurance are more likely to die in the hospital, they are more likely to miss school, more likely to not graduate, all kinds of ramifications if you do not have insurance.
Eye glasses, you can’t get eye glasses and you can’t see the board, you can’t do well in school, you’re a troublemaker. We have really, really pushed that kids should have health coverage. Unfortunately, they have now ratcheted back down a little bit, instead of all kids it’s now some kids again but it is up to 300% of poverty, which is still very good.
MP: Thank you so much for taking the time with me. You can be sure you have allies in the members of this Committee.
We invited Representative Gabel to join us for dinner during the ISBA Midyear Meeting but, unfortunately, she was ill and unable to do so. Gail Smith from CLAIM, however, did join us and we will be in close contact with her to track the progress of House Bill 1958. The Committee thanks Gail as well for her commitment to women and the law.