BILL ANALYSIS
AB 517
Page 1
Date of Hearing: April 14, 2009
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
AB 517 (Ma) - As Amended: April 13, 2009
SUBJECT : Safe Body Art Act.
SUMMARY : Establishes the Safe Body Art Act to provide minimum
statewide standards for the regulation of practitioners engaged
in the business of tattooing, body piercing, and the application
of permanent cosmetics in California. Specifically, this bill :
1)Repeals existing law governing the development of body art
standards for persons engaged in the business of tattooing,
body piercing, or permanent cosmetics.
2)Requires every body art practitioner to register with the
local enforcement agency (LEA) by June 10, 2010, and prohibits
a person from performing body art if he or she is not
registered with the LEA beginning on April 10, 2010.
3)Requires the applicant to provide specified information as a
condition of registration including, among other things, the
following: evidence of current Hepatitis B vaccination;
evidence of completion of training in bloodborne pathogens,
first aid, and CPR; proof that he or she is 18 years or older;
self-certification of knowledge and commitment to state law
and relevant local regulations; and payment of a registration
fee, to be determined by the LEA in an amount sufficient to
cover actual administrative costs.
4)Requires a practitioner to display the registration
certificate in a readily visible place at the facility where
the practitioner is performing body art and makes a valid and
current registration issued by a LEA valid in any other
jurisdiction for no more than five consecutive days, or 15
total, in any one calendar year.
5)Specifies that the bloodborne pathogens training pursuant to
3) above must be specific to the practitioner's practice and
meet specified criteria, including classroom training that
discusses specified elements.
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6)Directs an owner of a body art facility to provide the
specified bloodborne pathogens training to all employees,
contractors, and volunteers who perform duties within the
cleaning and sterilization area or procedure area of the
facility. Requires each person who completes the bloodborne
pathogens training to complete a minimum of two hours of
updated training each year.
7)Specifies that records of bloodborne pathogens training must
be maintained for three years and available for inspection
upon request of the LEA.
8)Prescribes a number of hygiene and sanitation procedures for a
practitioner to follow before performing body art and at the
completion of the procedure. Directs the practitioner to
maintain a clean and sanitary environment as specified.
9)Requires jewelry to meet specific sterilization and material
requirements prior to being placed in newly pierced skin.
10)Requires various specified products applied to the skin
before tattooing or application of permanent cosmetics to be
single use and properly discarded at the end of the procedure
unless the product can be disinfected for reuse.
11)Prescribes various requirements for commercially manufactured
inks, dyes, pigments, soaps, trays, single-use needles, needle
bars, grommets, razors, machines, and tools used in the
performance of body art.
12)Imposes various restrictions on the performance of body art
including that the client must be at least 18 years of age to
receive a tattoo or permanent cosmetics application,
regardless of parental consent; or, if under the age of 18,
the client must only receive a body or earlobe piercing in the
presence of, or with the written authorization of, a parent or
guardian.
13)Requires a client to read, complete, and sign an informed
consent form containing specified information and receive,
complete, and sign a questionnaire disclosing specified
information prior to the performance of body art.
14)Clarifies that body piercing does not include piercing an
earlobe with a disposable, single-use device stud or solid
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needle that is applied using a mechanical device to force the
needle or stud through the ear. Requires sites that perform
this activity to meet specified registration, sanitation, and
training requirements.
15)Prohibits a body art facility from conducting business
without a valid health permit issued by a LEA and requires the
application for a health permit to include a copy of the
facility's infection prevention control plan and a specified
fee as determined by the LEA.
16)Specifies that the health permit is valid only for the
location of the facility and the time period indicated on the
permit and is non-transferable. Requires the health permit
and certificates of registration for all practitioners
performing body art in the facility to be posted prominently
at the body art facility.
17)Requires a person who proposes to construct a practice site
or mobile practice site, other than a temporary body art event
booth, to submit plans and a specified fee to the LEA for
review. Requires the plans to be reviewed before any
building, plumbing, or electric permits are issued and
requires any corrective action to be taken and the site
approved to open before any body art can be performed.
18)Specifies that a facility's infection prevention control plan
pursuant to 15) above is required to identify procedures for
achieving compliance with certain requirements relating to
cleaning, disinfecting, packing, storing, and decontaminating
instruments and procedure sites during the performance of body
art. Requires the plan to include an inventory of all
chemicals and disinfectants, as specified.
19)Requires training on the facility's infection prevention
control plan to occur not less than once a year, and each time
that tasks in which occupational exposure may take place are
initially assigned, procedures or tasks change, and new
technology is adopted for use in the facility.
20)Specifies that records of infection prevention control plan
training must be maintained for three years and available for
inspection upon request of the LEA.
21)Requires a permanent body art facility to comply with
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specified building requirements and meet specified standards
for procedure areas and cleaning and sanitation areas within
the facility.
22)Requires a body art facility to conform to a number of
specified sterilization procedures and maintain sterilization
records.
23)Specifies that a practitioner who performs body art in a
vehicle in a jurisdiction for more than seven days in a
consecutive 90-day period is required to obtain a health
permit from the LEA in that jurisdiction. States that a
vehicle that will be operating in the jurisdiction for less
than seven days in a consecutive 90-day period is a temporary
demonstration booth subject to the requirements in this bill
governing temporary body art facilities.
24)Allows a practitioner to operate in a temporary demonstration
booth for a maximum of seven days in a 90-day period in the
local jurisdiction of registration provided that the booth
meets certain specified requirements.
25)Requires the sponsor of a temporary body art event to apply
for and obtain a sponsor's health permit from the LEA in the
jurisdiction where the event will be held and makes the
sponsor responsible for ensuring the availability of support
facilities and supplies for practitioners and vendors as
specified.
26)Permits a LEA officer to enter a body art facility during the
facility's hours of operation and other reasonable times to
conduct specified inspection and compliance activities.
Requires the LEA officer, upon completion of these activities,
to make a written report and furnish a copy to the owner or
practitioner.
27)Authorizes a LEA officer to impound any instruments found to
be unsafe based upon the inspection findings or other evidence
and requires the LEA to initiate proceedings to release the
impounded instrument or seek remedies for its disposal within
30 days.
28)Makes it a violation of this bill for the owner or any person
working in a body art facility to conceal or withhold records
or evidence, interfere with the performance of a LEA officer,
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or knowingly falsify or misrepresent information required to
be submitted or maintained by this bill. Allows a LEA to
suspend a certificate of registration or health permit for a
violation of this bill.
29)Requires a body art facility or practitioner whose
certificate of registration or health permit has been
suspended to cease doing business until the certificate or
permit has been reinstated. If a body art facility's health
permit has been revoked, the facility is required to remain
closed until a new permit is issued.
30)Provides for specified due process whenever a LEA officer
finds that a practitioner or body art facility is not in
compliance with the requirements of this bill.
31)Makes it a misdemeanor to perform body art without being
registered, operate a body art facility without a health
permit, or operate a temporary body art event without a health
permit, and authorizes the LEA to assess an administrative
penalty of $25 to $1,000 for the violation of any provision of
this bill.
32)Allows a city, county, or city and county to adopt
regulations and ordinances that do not conflict with, or are
more comprehensive than, the provisions of this bill.
Specifies that a regulation or ordinance enacted by a local
jurisdiction that conflicts with the provisions of this bill
remains in effect, to the exclusion of the conflicting
provision of this bill, until January 1, 2012.
33)Defines various terms for purposes of this bill.
EXISTING LAW :
1)Makes it a misdemeanor to tattoo or offer to tattoo a person
under the age of 18.
2)Requires the California Conference of Local Health Officers
(CCLHO) to establish sterilization, sanitation, and safety
standards for persons engaged in the business of tattooing,
body piercing, or permanent cosmetics.
3)Requires the Department of Public Health (DPH) to provide the
necessary resources to support the development of these
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standards and requires the standards to be directed at
establishing and maintaining sterile conditions and safe
disposal of instruments.
4)Allows the standards to be modified as appropriate to protect
consumers from transmission of contagious diseases through
cross-contamination of instruments and supplies.
5)Requires the standards to be submitted to DPH for review and
consultation by July 1, 1998, and directs DPH to distribute
those standards in written form to all county health
departments (CHDs) within 30 days after they are adopted by
DPH.
6)Requires persons engaged in the business of tattooing, body
piercing, or permanent cosmetics to register with the CHD by
December 31, 1998, as specified.
7)Requires a registrant to obtain a copy of DPH's standards from
the CHD, provide the CHD with his or her business address, and
pay a one-time $25 registration fee and an annual $105
inspection fee to the CHD. States that the county is not
precluded from charging an additional amount if necessary to
cover the cost of registration and inspection.
8)Requires each CHD to conduct annual inspections of the
locations at which registrants conduct regulated activities.
9)Authorizes a county to adopt any regulations that do not
conflict with, or are more comprehensive than, current law or
with the standards adopted by DPH.
10)States that current law does not limit a county's ability to
require a registrant to obtain any business license or permit
that the county finds appropriate.
11)Specifies that in those jurisdictions where the local health
officer and the environmental health director are in separate
departments, the county or city has the option to choose the
entity responsible for enforcement.
12)Subjects a person who fails to register or violates the
sterilization, sanitation, and safety standards after December
31, 1998, to a $500 civil penalty per violation as specified.
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13)Requires any person seeking to engage in the business of
tattooing, body piercing, or permanent cosmetics to comply
with the requirements in current law by January 1, 1999.
14)Requires a task force consisting of specified members to be
formed for the purpose of recommending legislation to the
Legislature concerning licensing, training, sanitation, and
other subjects deemed necessary to protect the health and
welfare of persons seeking the services of body art
practitioners.
FISCAL EFFECT : This bill has not yet been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . The sponsors of this bill, the
California Association of Environmental Health Administrators
(CAEHA), the Health Officers Association of California (HOAC),
and the Association of Professional Piercers (APP) maintain
that, despite requirements in existing law and repeated calls
from both health practitioners and established body art
professional trade associations, California still does not
have enforceable statewide standards that are sufficiently
detailed for consistent and effective local enforcement. The
sponsors point out that only seven of 62 cities and counties
with public health and environmental health agencies have
comprehensive local programs that register and inspect body
art practitioners and their operations and facilities.
According to the sponsors, the current lack of enforceable
statewide standards puts public health at risk, provides an
uneven playing field for the industry, and does not
accommodate reciprocity between local jurisdictions of
registered practitioners. This bill is intended to prevent
"back-street" tattooing and piercings in unsanitary sites by
unregistered practitioners and set forth appropriate
regulatory standards for all industry stakeholders.
2)BACKGROUND . The CCLHO is an organization of all legally
appointed health officers in the state that was created by the
Legislature in 1995 specifically to consult with, advise, and
make recommendations to state departments, boards, commissions
and officials of federal, state, and local government, the
Legislature, and any other organization or association on
matters affecting health. Pursuant to AB 186 (Brown), Chapter
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742, Statutes of 1997, which establishes a statutory scheme to
regulate body art practitioners, CCLHO is directed to
establish sanitation and safety guidelines and DPH is required
to review and adopt them as standards. According to the
CCLHO, it has been working with an affiliate organization, the
California Conference of Directors of Environmental Health,
for over 10 years to draft these guidelines and urge DPH to
adopt them as standards. CCLHO states that it has been
concerned that the draft guidelines would be unenforceable and
considered "underground" regulations unless formally adopted
by DPH. However, in January 2008, DPH issued a memo
concluding that regulations are not necessary as current law
does not explicitly require DPH to adopt these standards. DPH
contends in the memo that while current law makes reference to
the adoption of these standards by DPH, these references do
not reflect the intent by the Legislature for DPH to adopt
regulations. Rather, DPH maintains in the memo that it was
the intent of the Legislature that, following DPH's review and
consultation of the standards established by the CCLHO, DPH
would distribute the standards to each CHD.
3)LEGISLATIVE COUNSEL OPINION . In response to the memo from
DPH, the CCLHO obtained an opinion from the Office of
Legislative Counsel in October 2008 to determine whether DPH's
decision not to adopt the CCLHO standards as state regulations
precluded enforcement of the standards by a county that has
not adopted them as local regulations. Based on an
examination of the legislative history of AB 186 which changed
the entity required to establish the standards from DPH to the
CCLHO, Legislative Counsel found that the Legislature did not
intend to require DPH to adopt the standards. Consequently,
Legislative Counsel concluded that DPH is not required to
adopt the CCLHO standards in order for those standards to be
enforceable.
4)LOCAL ORDINANCES . According to the sponsors, in the absence
of statewide standards, several local governments in
California have enacted comprehensive body art ordinances,
including Los Angeles, Orange, Monterey, San Francisco, Santa
Clara, San Mateo, and San Diego. Other counties, such as
Sonoma, Kern, and Marin, are considering adoption, but it is
likely that they will not proceed if this bill is enacted.
5)PRIOR LEGISLATION .
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a) AB 186 (Brown), Chapter 742, Statutes of 1997, requires
the CCLHO to establish safety and sterilization standards
for body art practitioners; requires practitioners to
register with and pay a fee to the LEA in their
jurisdiction; requires LEAs to conduct annual inspections;
and, establishes a task force to recommend legislation to
address the health of persons seeking tattooing, body
piercing, and permanent cosmetics.
b) SB 1360 (Senate Committee on Health and Human Services),
Chapter 415, Statutes of 1995, creates the CCLHO to serve
as an advisory body to specified entities on matters
affecting health.
6)SUPPORT . The sponsors of this bill, CAEHA, HOAC, and APP,
note that this bill is a culmination of collaborative efforts
between public health and environmental health
representatives, individual practitioners, and body art trade
associations to ensure that statewide standards are not only
protective of public health, but fair and reasonably
enforceable. HOAC points out in particular that this bill
will mitigate the potentially serious public health risks
associated with unregulated body art by requiring
practitioners to register with their local county and comply
with requirements related to vaccinations, bloodborne
pathogens training, and site inspections. Supporters,
including individual CHDs and body art industry associations,
add that by clearly establishing scope of local authority,
practitioner registration requirements, and consistent
enforcement of mobile and fixed body art sites, this bill
represents a significant step in the way body art is regulated
and helps to protect the health of practitioners and their
clients.
7)SUPPORT IF AMENDED . The Blood Centers of California support
this bill if it is amended to require the use of sterile
needles and single use of commercially manufactured inks,
dyes, and pigments in order to reduce the risk of clients'
exposure to bloodborne diseases like HIV or hepatitis from
multiple use needles or ink.
8)COMMENTS .
a) Registration documentation . This bill requires a
registered practitioner to display a certificate confirming
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registration in a readily visible place at the body art
facility and specifies what constitutes a valid and current
registration. Given that each LEA is unlikely to provide
one consistent form of registration, should this bill be
amended to refer to a registration document rather than a
certificate?
b) Commercially manufactured items . This bill requires
only commercially manufactured inks, dyes, and pigments to
be used in the practice of tattooing or the application of
permanent cosmetics. However, the bill also specifies that
products including stencils and marking and transfer agents
are also used. The author may wish to amend this bill to
clarify whether these items should also be required to be
commercially manufactured.
c) Infection prevention training . This bill requires
training on a body art facility's infection prevention
control plan to take place when tasks where occupational
exposure may occur are initially assigned. The author may
wish to amend this bill to specify what these tasks may be
and clarify what is meant by "initially assigned."
9)SUGGESTED TECHNICAL AMENDMENTS .
a) The requirement in this bill to maintain records of
training does not specify where the records should be kept.
Consistent with the sponsors' intent, this should be
clarified on page 11, lines 19-20, and page 16, lines 34-35
as follows:
"Records of training required pursuant to this section
shall be maintained for three years in the facility"
b) On page 19, line 30, after "a" add "consecutive" and
line 36, after "temporary" add "demonstration".
c) On page 20, line 25, after "sponsor's" add "health".
d) On page 22, line 27, after "revoked" add ", pursuant to
Section 119322,".
e) On page 23, line 35, after "a" add "health".
REGISTERED SUPPORT / OPPOSITION :
Support
Association of Professional Piercers (sponsor)
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California Association of Environmental Health Administrators
(sponsor)
Health Officers Association of California (sponsor)
American Federation of State, County and Municipal Employees,
AFL-CIO
California Alliance for the Promotion of Safe Body Art
California Environmental Health Association
City of Vernon
Monterey County Department of Health
San Francisco Department of Public Health
Opposition
None on file.
Analysis Prepared by : Cassie Rafanan / HEALTH / (916)
319-2097