BILL ANALYSIS Ó AB 300 Page 1 Date of Hearing: March 22, 2011 ASSEMBLY COMMITTEE ON HEALTH William W. Monning, Chair AB 300 (Ma) - As Amended: March 10, 2011 SUBJECT : Safe Body Art Act. SUMMARY : Imposes 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)Prohibits a person from performing body art if he or she is not registered with the local enforcement agency (LEA). 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 days total, in any one calendar year. Requires a practitioner's registration to be renewed annually. 5)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. 6)Prescribes various requirements for commercially manufactured inks, dyes, pigments, soaps, trays, single-use needles, needle AB 300 Page 2 bars, grommets, razors, machines, and tools used in the performance of body art. 7)Imposes various restrictions on the performance of body art including informed consent and client disclosure requirements, as specified. 8)Requires sites that only perform mechanical stud and clasp ear piercing to meet separate notification, sanitation, training, and equipment requirements. 9)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 and Control Plan and a specified fee as determined by the LEA. 10)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. 11)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. 12)Specifies that, if a practitioner performs body art in a vehicle in a jurisdiction for more than seven days in a consecutive 90-day period, the practitioner is required to obtain a health permit from the LEA in that jurisdiction. Requires a vehicle that will be operating in the jurisdiction for less than seven days in a consecutive 90-day period to be treated as a temporary demonstration booth, as specified. 13)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. AB 300 Page 3 14)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 to make a written report and furnish a copy to the owner or practitioner upon completion of an inspection or investigation. 15)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, 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. 16)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. 17)Requires practitioners, body art facility owners, and sponsors of temporary body art events to obtain and pay for necessary registration and permits, as specified. 18)Makes it a misdemeanor to perform body art without being registered; operate a body art facility or operate a temporary body art event without a health permit. Authorizes the LEA to assess an administrative penalty of $25 to $1,000 for a violation of any provision of this bill. 19)Allows a city, county, or city and county to adopt regulations or ordinances that do not conflict with, or are more stringent than, the provisions of this bill. 20)Defines various terms for purposes of this bill. 21)Makes the provisions of this bill operative on July 1, 2012. 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. AB 300 Page 4 3)Requires the Department of Public Health (DPH) to provide the necessary resources to support the development of these 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 LEAs 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 LEA by December 31, 1998, as specified. 7)Requires a registrant to obtain a copy of DPH's standards from the LEA, provide the LEA with his or her business address, and pay a one-time $25 registration fee and an annual $105 inspection fee to the LEA. 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 LEA 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)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. 12)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. AB 300 Page 5 13)Requires a task force consisting of specified members to be convened to make recommendations to the Legislature with regard to licensing, training, sanitation, and other related issues in order 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 . According to the author, the state lacks enforceable and sufficiently detailed statewide standards regulating body art despite requirements in existing law and repeated efforts from both health practitioners and established body art professional trade associations. This bill is jointly sponsored by the California Association of Environmental Health Administrators, the Health Officers Association of California, the Association of Professional Piercers, and the Alliance of Professional Tattooists to establish a uniform body of law to promote safer body art practices and assist these small businesses by streamlining the patchwork of local regulations. 2)BACKGROUND . The Pew Research Center reported in 2007 that 36% of young people between the ages of 18 and 25 had a tattoo and 30% had a body piercing somewhere other than their ear, while 40% of those age 26 to 40 had a tattoo and 22% had a body piercing somewhere other than their ear. Serious health risks are associated with unsafe tattooing and piercing practices, including allergic skin reactions from tattoo dye, local bacterial infections, nerve damage from piercing, complications during diagnostic imaging, and a host of blood-borne infections including hepatitis B, hepatitis C, tetanus, and HIV. Tattoo inks are classified as cosmetics and therefore are not regulated by the federal Food and Drug Administration. Long-term effects of these inks are unknown. Branding is the process in which a mark, usually a symbol or ornamental pattern, is burned into human skin tissue with a hot iron or other instrument, with the intention that the resulting scar makes it permanent. It is often used as a form of initiation in fraternities, gangs, and prison groups, but AB 300 Page 6 can also be a strictly decorative procedure when performed at a body art facility. While it is not as popular or as common as other forms of body art, it nonetheless carries distinct health risks because of the burning of human tissue. 3)DPH REGULATIONS . AB 186 (Brown), Chapter 742, Statutes of 1997, establishes a statutory scheme to regulate body art practitioners. The sponsors note that they have been working for over 10 years to draft sanitation and safety guidelines and urge DPH to adopt them as standards. 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 that it was the intent of the Legislature that, after reviewing the standards, DPH would distribute them to each LEA. A 2008 opinion of the Office of Legislative Counsel opined that the Legislature did not intend to require DPH to adopt the standards 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. Consequently, Legislative Counsel concluded that DPH is not required to adopt the standards as regulations in order for them to be enforceable. 4)PRIOR LEGISLATION . a) AB 223 (Ma) of 2010, and AB 517 (Ma) of 2009, both of which were substantively identical to this bill, were vetoed by Governor Schwarzenegger. In his veto messages the Governor stated that he did not see a compelling need for additional legislation, given that body art guidelines were developed several years ago, local jurisdictions have the option to establish these requirements in their own county, and many have chosen to do so, and, if the sponsors wanted a bill that addressed the purported problem, a simple statutory authorization for DPH to promulgate standardized regulations would have been acceptable. AB 300 Page 7 b) AB 186 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. 5)SUPPORT . The sponsors of this bill state that it represents an extensive multi-year collaborative effort between public health and environmental health representatives, individual practitioners, and body art trade associations to ensure that the statewide standards developed in this bill are not only protective of public health, but fair and reasonably enforceable. Supporters add that these standards are long-overdue and will, among other things, establish clear scope of local authority, provide clear requirements for practitioner registration, establish consistent enforcement of mobile and fixed body art sides, protect clients through informed consent requirements, and enhance practitioners' knowledge of bloodborne pathogen exposure control. 6)TECHNICAL AMENDMENT . On page 17, line 30, change "decontaminted" to "decontaminated". REGISTERED SUPPORT / OPPOSITION : Support Alliance of Professional Tattooists (sponsor) Association of Professional Piercers (sponsor) California Association of Environmental Health Administrators (sponsor) Health Officers Association of California (sponsor) Alpine County Public Health Department Blood Centers of California Body Manipulations California Alliance for the Promotion of Safe Body Art California Chapters of the American Red Cross California Environmental Health Association City of Vernon County of San Bernardino County of Santa Clara Board of Supervisors Humboldt County Department of Health and Human Services Lake County Health Services Department AB 300 Page 8 Madera County Public Health Department Marin County Environmental Health Services Mariposa County Public Health Department National Environmental Health Association San Joaquin County Environmental Health Department Opposition None on file. Analysis Prepared by : Cassie Royce / HEALTH / (916) 319-2097