Exhibit 6

Sheriff's Office

/

ISSUANCE DATE

EFFECTIVE DATE

NO.

COOK COUNTY, ILLINOIS

/

SHERIFF'S ORDER
07 FEB 11
DISTRIBUTION

SUBJECT

SECURITY SPECIAL SITUATIONS:
PREGNANT ARRESTEES /
DET AINEES / INMATES

G

RELATED DIRECTIVES

I.

14 FEB 11

11.5.30.1

RESCINDS

11.5.30.0
AMENDS

PURPOSE
This order establishes policy and procedure regarding the security of pregnant subjects in
the custody of the Cook Count ~heriffs Office (CCSO).

II.

POLICY
The Cook County Sheriff s Office strictly prohibits the use of security restraints on pregnant
subjects in custody absent unusual circumstances. All departments of the CCSO who
transport or escort any subject in custody who is known to be pregnant for medical attention
will notify the Cook County Sheriff's
wiII
Sheriffs Office Department of Women's Justice Services
(DWJS) immediately as outlined in this directive. In cases that require DWJS staff to
respond to the scene, upon arrival the DWJS staff will assume responsibility for managing
security to include the use of security restraints on the pregnant/post partum subjects in
unusual circumstances. The CCSO staff on the scene will assist in managing safety and
security of the subject.
This Sheriffs Order shall not be construed to limit the authority of medical personnel to
order therapeutic restraints for a pregnant or postpartum subject who, in their
professional opinion, is a danger to herself, her child, unborn child, or other persons due
to a psychiatric or medical disorder. Whenever therapeutic restraints are used by
medical personnel, Section 2-108 of the Illinois Mental Health and Developmental
Disabilities Code shall apply.

AUTHORITY
County Jail Act (730 ILCS 125/17.5)
125117.5) Pregnant female prisoners.

IV.

V.

ENCLOSURE
A.

Pregnant Subject Medical Incident Part 1 (FCN-Ol)(Jan 11)

B.

Pregnant Subject Medical Incident Part 2 (FCN-02)(Jan 11)

DEFINITIONS
For the purpose of this order, the following definitions will apply:

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~o

11.5.30.1

A.

Hospital room - any room/area within the hospital where a subject is located
during her stay.

B.

Medical personnel- any individual recognized or licensed by the State of Illinois as
a nurse, physician, physician assistant, paramedic, or other emergency medical
technician.

C.

Pregnant subject - any subject in custody of the Cook County Sheriff's Office who
is verified by medical personnel to be pregnant or whose physical appearance is
such that her pregnancy would be obvious to a lay person. A female subject who
claims to be pregnant but is not visibly pregnant will be referred to medical
personnel to ascertain whether she is pregnant.

D.

Security Restraints - Any device or equipment designed to be applied to a
subject's body which is intended to restrict movement. The following are
categories of security restraints:

1.
2.
3.
4.
5.
E.

Electronic control device
Emergency restraint chair
Handcuffs
Leg irons/shackles
Waist restraint system (blue box and belly chains)

Subject - Any individual that an officer comes in contact with including, but not
limited to, the following subcategories:
1.

Arrestee - a subject who is being criminally charged by a sworn member
of the Cook County Sheriffs Office with a violation of State Law or
County Ordinance.

2.

Detainee - a subject in the lawful custody of the Sheriff s Office prior to
a court order.

3.

New Inmate - a subject in the custody of the Sheriffs Office pursuant to
a court order who have not completed the Cook County Department of
Corrections admissions process.

4.

Inmate - a subject in the custody of the Cook County Department of
Corrections pursuant to a court order.

F.

Therapeutic Restraints - a therapeutic intervention initiated, monitored and
discontinued only by qualified and authorized health staff, to use authorized
devices designated to safely limit a patient's mobility for medical or psychiatric
reasons. Metal handcuffs or shackles are not considered therapeutic restraints.

G.

Unusual circumstance - a substantial flight risk or some other unusual security
circumstance that dictates restraints be used to ensure the safety and security of
2

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or the public.

VI.

VII.

RESPONSIBILITIES
A.

It is the responsibility of Sheriffs Office employees to ensure that security restraints
are not applied on a pregnant subject for any reason absent unusual circumstances.
Officers will check the status indicated on the inmate's Cook County Department of
Corrections (CCDOC) yellow identification card prior to placing security restraints
on the inmate.

B.

Supervisors must allow for an adequate number of officers to provide security for a
subject, and this will include accounting for the subject's risk classification,
transportation requirements, location and officer relief factors.

C.

It is the responsibility of Cermak Health Services, upon verification of pregnancy, to
identify all pregnant new inmates/inmates in the jail information system by posting a
medical alert in IMACS.

D.

It is the responsibility of the CCDOC Reception, Classification, Diagnostic Center
(RCDC) Staff to issue a yellow CCDOC identification card to new inmates claiming
to be pregnant. Continued possession of the yellow identification card will be
pursuant to medical verification that the inmate is pregnant. Upon medical
verification the subject is not pregnant RCDC will immediately reissue the
appropriate CCDOC identification card.

PROCEDURE
A.

Officer's Notifications/Reporting
When a pregnant subject requires immediate medical attention or requests
immediate medical attention, the responding officer shall:
1.

ensure medical attention is provided/contacted.

2.

notify immediate supervisor to convey the following information:
a.

That medical personnel have been contacted and the general reason
why they were contacted.

b.

The subject is visibly pregnant, is claiming to be pregnant or
possesses a yellow CCDOC identification card.

c.

Subject's current location.

d.

Any special security/high risk factors.

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SOGO 11.5.30.1

B
B..

3.

Document the incident using the Pregnant Subject Medical Incident Form
Part 1I and any other applicable reports. This form must be completed by the
initiating department whenever a pregnant subject requires transportation for
immediate medical attention. Upon completion, the Pregnant Subject
immediately
iately forwarded to the OWlS, fax
Medical Incident Form must be immed
number (773) 674-3962.

4.

Complete Pregnant Subject Medical Incident Form Part 2.

Supervisor' s Notifications/Reporting
A supervisor from the initiating department shall notify OWlS Security Office
located in Division 17 at (773) 674-6793 that a pregnant subject is receiving medical
attention. The supervisor shall convey the following information including, but not
limited to:

C.

1.

That medical personnel have been contacted and the general reason why they
were contacted.

2.
2.

The subject is visibly pregnant, is claiming to be pregnant or the inmate's
identification card indicates that medical personnel verified that she is
pregnant.

3.

Subject's current location.

4.

Subject's destination (including departure time, estimated time of arrival,
and if available any indication by medical staff of the duration of the stay).

5.

If security restraints have been employed and if a medical evaluation has
been requested/conducted.

6.

Security assessment concerns/resolutions (including contraband and
personnel concerns).
concerns).

7.

Any special security/high risk factors.

Security Assessment

1.
I.

Upon arrival at a hospital, clinic or any other destination the transporting
officer will complete an initial security assessment of the surroundings. This
will include but not be limited to a thorough search of the room, surrounding
areas, adjoining rooms, cabinets and containers that may be accessible or
contain contraband. The assessment will conclude with the officer standing
at the head of the bed and conducting visual inspection of the room prior to
the subject being brought in. Points of egress will be observed and noted
including but not limited to doors, windows, fire escapes etc.

4
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SOGO 11.5.30.1

D
D..

2.

An immediate notification to the officer'
officer'ss direct supervisor shall occur
informing the supervisor of any security concerns. The supervisor will assess
the risk and allocate the appropriate amount of staff required to secure the
area.

3.

Any contraband or other items that are deemed a security risk (e
(e.g.
.g. biohazard
disposal containers, syringes, and sharps) shall be noted and a request for its
removal from the immediate area will be made to the medical staff. The
officers will remain in the room with the subject until the security risk has
been removed or otherwise been addressed. In either instance the immediate
supervisor will be notified.

Security
I.

General Procedures
Officers will:
a.

Be posted immediately outside the door of the hospital room
room.. The
door shall remain open (except during medical examinations and/or
delivery) and visual supervision of the subject shall be maintained.

b.

Conduct a security assessment at irregular intervals not to exceed 30
minutes.

c.

Conduct a security assessment prior to medical staff entering and
after medical staff exits the hospital room, except in the case of a
medical emergency

d.

Ensure privacy is afforded to the subject while medical staff
conducts any examination, treatment or other procedures. In
situations where officers cannot physically be outside of the area, the
privacy/modesty curtain or panel provided by the medical facility
will be utilized to provide an acceptable level of privacy and dignity
while maintaining the appropriate level of security.

e.

Restrict the subject's movement to the confines of the hospital room,
unless provided written notification by medical staff to allow the
subject additional movement.

f.

Allow the subject to use the bathroom as needed.

g.

Permit the subject to shower at the direction of medical staff or in
accordance with the County Jail Standards.

h.

Not permit the subject to have visitors and will not permit the use of
the telephone without department head approval or a court order.

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SOGO 11.5.30.1

2.

3.

E.

I.

Not permit the subject use of a computer, mobile communication
device or access to the internet.

J.

If approved by medical staff, permit the newborn infant to be
brought into the subject's hospital room, absent any unusual
circumstance.

k.

If approved by medical staff, escort the subject to the neo-natal
neo-natal
intensive care unit or nursery to see the subject's newborn infant,
absent any unusual circumstance.

I.

If the subject is exhibiting any unusual behaviors, such as
credible/substantial flight risk or shows signs of harming herself,
others or the newborn child, immediately seek medical attention for
evaluation and possible use of therapeutic restraints.

Postpartum Subjects
a.

Postpartum subjects will not be placed in security restraints for the
duration of her hospital stay absent any unusual circumstance.

b.

Upon discharge from a medical facility, postpartum subjects shall be
restrained with handcuffs in front of the body, unless prohibited by
medical staff, during return transportation.

Transportation Procedures
a.

At no time will pregnant subjects be placed in restraints for any
reason during transportation, absent unusual circumstances.

b.

Pregnant subjects transported by the CCDOC Transportation Unit
will be seated immediately in the first seats in the front of the bus
and will be under constant visual supervision by the transportation
officer.

Unusual Circumstances
1.

Officers shall not apply security restraints to a subject known to be pregnant
or in postpartum recovery unless the officer makes an individualized
determination that the subject presents an unusual circumstance. The officer
shall immediately remove all security restraints upon the request of medical
personnel. The medical personnel requesting the removal of security
restraints must indicate name and provider number on the Pregnant Subject
Medical Incident Part 2.

2.

Officers will immediately report any use of security restraints on a pregnant
subject to their immediate supervisor and DWJS Security Office located in
Division 17 at (773) 674-6793.

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SOGO 11.5.30.1

3.

F.

Employing security restraints in any manner to a pregnant subject is
considered a use of force and will be reported in accordance with the current
CCSO Response to Resistance/ Use of Force Policy and a copy will be faxed
to OWlS (773) 674-3962.

Department of Women's lustice Services
The OWlS supervisor on duty will evaluate each incident at the time it is reported
and determine what OWlS response is appropriate. Based on the initial department's
supervisor debriefing, the officer's initial security assessment, subject's risk
classification, transportation requirements, location, general reason for the medical
encounter and officer relief factors the OWlS supervisor will:
1.

Communicate with the transporting officer's supervisor regarding the
assignment of additional officer(s) to provide additional security, when
necessary.

2.

Deploy OWlS Staff to the subject's location. Upon arrival, OWlS will
assume responsibility for managing security to include the use of security
restraints.

3.

Make recommendations to the initial department's supervisor.

4.

Report the use of security restrains on a pregnant subject immediately to the
OWlS Director of Security or designee, who will notify the OWlS
Executive Director or designee, who will notify the appropriate Deputy
Chief of Staff.

VIII. APPLICABILITY
By order of the Sheriff of Cook County, this Sheriffs Order applies to all applicable CCSO
employees and must be strictly observed. Any conflicts with existing directives shall be
resolved in favor of this Sheriffs Order.

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