BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                   AB 300|
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                                 THIRD READING


          Bill No:  AB 300
          Author:   Ma (D), et al.
          Amended:  8/24/11 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  9-0, 6/8/11
          AYES:  Hernandez, Strickland, Alquist, Anderson, Blakeslee, 
            De León, DeSaulnier, Rubio, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  7-0, 6/27/11
          AYES:  Kehoe, Alquist, Emmerson, Lieu, Pavley, Price, 
            Steinberg
          NO VOTE RECORDED:  Walters, Runner

           ASSEMBLY FLOOR  :  71-0, 4/11/11 - See last page for vote


           SUBJECT  :    Safe Body Art Act

           SOURCE  :     Alliance of Professional Tattooists
                      Association of Professional Piercers
                      California Association of Environmental Health 
          Administrators
                      Health Officers Association of California 


           DIGEST  :    This bill enacts the Safe Body Art Act providing 
          for minimum statewide standards for the regulation of 
          individuals in the business of tattooing, body piercing, 
          and the application of permanent cosmetics.  The provisions 
          will take effect on July 1, 2012.

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           Senate Floor Amendments  of 8/24/11 specify that the 
          activities of a physician assistant are not restricted by 
          this bill.

           ANALYSIS  :    

          Existing law:

          1. 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.

          2. 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.

          3. Allows the standards to be modified as appropriate to 
             protect consumers from transmission of contagious 
             diseases through cross-contamination of instruments and 
             supplies, as specified.

          4. 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 within 30 days of adoption by DPH.

          5. Requires a practitioner of tattooing, body piercing or 
             permanent cosmetics to register with the county in which 
             the business is conducted, obtain the sterilization, 
             sanitation, and safety standards distributed by DPH, as 
             specified, and pay a one-time registration fee of $25. 

          6. Allows the county to charge an additional fee, if 
             necessary, to cover the cost of registration and 
             inspection, and allows a county to adopt regulations 
             that do not conflict with, or are more comprehensive 
             than, standards adopted by DPH. 

          7. Makes a person liable for a civil penalty for the 
             failure to register or for a violation of the 

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             sterilization, sanitation and safety standards.  

          8. Makes it a misdemeanor to tattoo, or offer to tattoo, a 
             person under the age of 18, and makes it an infraction 
             for any person to offer or perform body piercing upon a 
             person under the age of 18, unless the body piercing is 
             performed in the presence of, or as directed by, a 
             notarized writing by the person's parent or guardian, 
             unless the person is an emancipated minor.

          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/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/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 an 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. Requires, for first-time registrants, documentation 
             evidencing a minimum of six months' related experience.  
             The local enforcement agency may require documentation 
             that includes, but is not limited to, dates, type, and 
             location of work, and the name and contact information 

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             of the registrant's supervisor(s).

          6. 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. 

          7. 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. 


          8. Imposes various restrictions on the performance of body 
             art including informed consent and client disclosure 
             requirements, as specified. 

          9. Requires sites that only perform mechanical stud and 
             clasp ear piercing to meet separate notification, 
             sanitation, training, and equipment requirements. 

          10.Prohibits a body art facility from conducting business 
             without a valid health permit issued by an 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. 

          11.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. 

          12.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. 

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          13.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. 

          14.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. 

          15.Permits an 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. 

          16.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 an LEA officer, or knowingly falsify or 
             misrepresent information required to be submitted or 
             maintained by this bill. Allows an LEA to suspend a 
             certificate of registration or health permit for a 
             violation of this bill. 

          17.Provides for specified due process whenever an LEA 
             officer finds that a practitioner or body art facility 
             is not in compliance with the requirements of this bill. 


          18.Requires practitioners, body art facility owners, and 
             sponsors of temporary body art events to obtain and pay 
             for necessary registration and permits, as specified. 

          19.Makes it a misdemeanor to perform body art without being 
             registered or to operate a body art facility or 

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             temporary body art event without a health permit.  
             Authorizes the LEA to assess various administrative 
             penalties. 

          20.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. 

          21.Makes the provisions of this bill operative on July 1, 
             2012. 

          22.Defines "sponsor" of a temporary body art facility.

          23.Permits an LEA to set fees that are sufficient to cover 
             the administrative and enforcement costs of providing 
             permits to the sponsor of and practitioner related to 
             temporary body art facilities.

          24.Clarifies that the sponsor and the practitioner would 
             both be responsible for obtaining all relevant permits 
             to conduct the business of a temporary body art facility 
             and would both be subject to penalties if found in 
             violation.

          25.Specifies that the activities of a physician assistant 
             are not restricted by this bill.

           Background  

           Health concerns associated with body art  .  In 2007, the Pew 
          Research Center reported that 36 percent of young people 
          between the ages of 18 and 25 had a tattoo and 30 percent 
          had a body piercing somewhere other than their ear, and 
          that 40 percent of those age 26 to 40 had a tattoo and 22 
          percent had a body piercing somewhere other than their ear. 
           

          Unsafe tattooing and piercing practices can lead to serious 
          health impacts such as hepatitis or HIV infection, as well 
          a range of other bloodborne infections.  Complications are 
          fairly uncommon, given how common tattoos and piercings 
          are, but because body art breaches the skin, infections are 
          a risk, nevertheless.  Tattoo inks are classified as 
          cosmetics and, with limited exceptions, are not regulated 

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          by the Food and Drug Administration.  Long-term effects of 
          these inks are unknown.  Specific risks of tattoos include 
          bloodborne diseases, skin disorders, skin infections, 
          allergic reactions, and complications during diagnostic 
          imaging such as an MRI.  Piercing also carries risks, 
          including infection, allergies, nerve damage, and excessive 
          bleeding.  

          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 can also be a strictly decorative 
          procedure when performed at a body art facility.  Not as 
          popular or as common as other forms of body art, it 
          nonetheless poses distinct health risks due to the burning 
          of human tissue.  

           Prior Legislation
           
          AB 223 (Ma, 2010) and AB 517 (Ma, 2009), which were 
          substantively similar to AB 300, would have established the 
          Safe Body Art Act to provide comprehensive statewide 
          regulations on the body art industry.  In his veto messages 
          on the bills, Governor Schwarzenegger 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.  

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  Yes

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

            Major Provisions      2011-12     2012-13     2013-14       Fund 

           LEA start-up, ongoing         unknown, likely in the 
           millions of dollars           Local*
           administration      annually; fully supported by local 

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           fees,
                               commencing July 1, 2012

           * Although this bill enacts a state-mandated local 
            program, it does not meet the criteria for state 
            reimbursement because LEAs will have the authority to 
            impose fees for the administrative and enforcement costs 
            of this program. 
           
           SUPPORT  :   (Verified  6/30/11)

          Alliance of Professional Tattooists (co-source)
          Association of Professional Piercers (co-source) 
          California Association of Environmental Health 
          Administrators (co-source) 
          Health Officers Association of California (co-source)
          Alameda Alliance for Health
          Alpine County Public Health Department
          American Academy of Pediatrics, California District
          American Red Cross
          Blood Centers of California
          Body Manipulations
          California Chapters of the American Red Cross
          California Environmental Health Association
          California Hepatitis Alliance
          California Society of Dermatology and Dermatologic Surgery
          California State Association of Counties
          City and County of San Francisco
          City of Vernon
          County Health Executives Association of California
          County of San Bernardino
          County of Santa Clara Board of Supervisors
          County of Sonoma Department of Health Services
          Humboldt County Department of Health and Human Services
          Kaiser Permanente
          Lake County Health Services Department
          Marin County Environmental Health Services
          Mariposa County Public Health Department
          San Francisco Department of Public Health
          San Joaquin County Environmental Health Department
          Studex Corporation

           ARGUMENTS IN SUPPORT  :    The bill's sponsors, the 
          California Association of Environmental Health 

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          Administrators, the Health Officers Association of 
          California, the Association of Professional Piercers, and 
          the Alliance of Professional Tattooists 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.  

          Proponents of the bill state that this bill represents an 
          extensive multi-year effort between public health and 
          environmental health representatives, individual 
          practitioners and body art trade associations to ensure 
          that the statewide standards proposed are not only 
          protective of public health, but fair and reasonably 
          enforceable.  

          Blood Centers of California states that federal regulations 
          minimally require a one-year deferral from blood donation 
          for potential donors with tattoos and body piercings 
          performed in facilities that are not licensed or inspected 
          by the state, resulting in an estimated 100,000 deferrals 
          nationally.  The Blood Centers of California adds that this 
          deferral of otherwise healthy adults represents the loss of 
          a huge source of donor blood supply in the state.  The 
          Blood Centers of California contends that the standards and 
          regulations this bill provides will result in an increase 
          in potential blood donors in California.  


           ASSEMBLY FLOOR  :  71-0, 4/11/11
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, 
            Bill Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Brownley, Buchanan, Butler, Campos, Carter, Cedillo, 
            Chesbro, Conway, Cook, Davis, Dickinson, Donnelly, Eng, 
            Feuer, Fong, Fuentes, Furutani, Galgiani, Garrick, Gatto, 
            Gordon, Grove, Hagman, Hall, Harkey, Hayashi, Roger 
            Hernández, Hill, Huber, Hueso, Huffman, Jeffries, Jones, 
            Lara, Logue, Bonnie Lowenthal, Ma, Mendoza, Mitchell, 
            Monning, Nestande, Nielsen, Norby, Olsen, Pan, Perea, V. 
            Manuel Pérez, Portantino, Silva, Skinner, Smyth, Solorio, 
            Swanson, Torres, Valadao, Wagner, Wieckowski, Williams, 
            Yamada, John A. Pérez
          NO VOTE RECORDED:  Charles Calderon, Fletcher, Gorell, 

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            Halderman, Knight, Mansoor, Miller, Morrell, Vacancy


          CTW:mw  8/24/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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