BILL ANALYSIS Ó ------------------------------------------------------------ |SENATE RULES COMMITTEE | AB 300| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ 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. CONTINUED AB 300 Page 2 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 CONTINUED AB 300 Page 3 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 CONTINUED AB 300 Page 4 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. CONTINUED AB 300 Page 5 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 CONTINUED AB 300 Page 6 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 CONTINUED AB 300 Page 7 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 CONTINUED AB 300 Page 8 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 CONTINUED AB 300 Page 9 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, CONTINUED AB 300 Page 10 Halderman, Knight, Mansoor, Miller, Morrell, Vacancy CTW:mw 8/24/11 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED