California Legislature—2013–14 Regular Session

Assembly BillNo. 1168


Introduced by Assembly Member Pan

February 22, 2013


An act to amend Sections 119300, 119301, 119303, 119306, 119312, 119314, 119315, and 119318 of the Health and Safety Code, relating to body art.

LEGISLATIVE COUNSEL’S DIGEST

AB 1168, as introduced, Pan. Safe body art.

Existing law, the Safe Body Art Act, regulates the performance of body art, as defined, and the permitting of body art facilities. Existing law defines “body art facility” as the specified building, section of a building, or vehicle in which a practitioner performs body art. Under existing law, performing body art without being registered, operating a body art facility without a health permit, or operating a temporary body art event without a permit is a misdemeanor.

This bill would add to the definition of “body art facility” places where body art is demonstrated for the purpose of instruction. The bill would also prohibit the performance of body art at a place other than a permanent or temporary body art facility.

Existing law requires, prior to the performance of body art, a client to read, complete, and sign a questionnaire, which is considered confidential information. Existing law requires the body art facility to maintain the confidentiality of the information in the questionnaire and to shred the confidential medical information after 2 years.

This bill, instead, would require any information gathered in the questionnaire that is personal medical information and that is subject to the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) or similar state laws to be maintained or disposed of in compliance with those provisions.

Existing law requires a first-time registrant as a body art practitioner to provide documentation evidencing 6 months of related experience.

This bill would remove this provision.

Existing law establishes requirements for a body art facility to be granted a health permit and prohibits a facility from operating as a body art facility without that permit. A facility operating without a permit or other required licenses may be shut down by the local authority. Existing law specifies the requirements for a permitted body art facility, including floors, walls, and ceilings that are smooth, free of open holes, and washable.

This bill would authorize a county to suspend or revoke the health permit of a body art facility if a person who does not possess a valid practitioner registration is allowed to perform body art. The bill would also make specified changes to the requirements for a body art facility, including that the floors and walls must be nonabsorbent and that the facility provide adequate toilet facilities, as specified.

Existing law specifies the requirements for a temporary body art facility, including the provision of an eye wash station.

This bill would remove the requirement of an eye wash station at a temporary body art facility.

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

The people of the State of California do enact as follows:

P2    1

SECTION 1.  

Section 119300 of the Health and Safety Code
2 is amended to read:

3

119300.  

(a) This chapter shall be known, and may be cited,
4as the Safe Body Art Act.

5(b) The purpose of this chapter is to provide minimum statewide
6standards for the regulation of persons engaged in the businessbegin insert or
7performanceend insert
of tattooing, body piercing,begin insert branding,end insert and the
8application of permanent cosmetics in California. These
9requirements are intended to protect both the practitioner and the
10client from transmission of infectious diseases through the
11application of proper body art procedures and the control of
12cross-contamination of instruments and supplies.

P3    1

SEC. 2.  

Section 119301 of the Health and Safety Code is
2amended to read:

3

119301.  

For purposes of this chapter, the following definitions
4shall apply:

5(a) “Antiseptic solution” means a liquid or semiliquid substance
6that is approved by the federal Food and Drug Administration to
7reduce the number of microorganisms present on the skin and on
8mucosal surfaces.

9(b) “Bloodborne pathogen” means a disease-causing
10microorganism that, when present in the blood, can be transmitted
11to humans, including, but not limited to, hepatitis B virus (HBV),
12hepatitis C virus (HCV), and human immunodeficiency virus
13(HIV).

14(c) “Body art” means body piercing, tattooing, branding, or
15application of permanent cosmetics.

16(d) “Body art facility” means the specified building, section of
17a building, or vehicle in which a practitioner performsbegin insert, or
18demonstrates for the purpose of instruction,end insert
body art, including
19reception areas, the procedure area, and the decontamination and
20sterilization area. “Body art facility” does not include a facility
21that only pierces the ear with a disposable, single-use, presterilized
22clasp and stud or solid needle that is applied using a mechanical
23device to force the needle or stud through the ear.

24(e) “Body piercing” means the creation of an opening in a human
25body for the purpose of inserting jewelry or other decoration.
26“Body piercing” includes, but is not limited to, the piercing of an
27ear, including the tragus, lip, tongue, nose, or eyebrow. “Body
28piercing” does not include the piercing of an ear, except for the
29tragus, with a disposable, single-use, presterilized stud and clasp
30or solid needle that is applied using a mechanical device to force
31the needle or stud through the ear.

32(f) “Branding” means the process in which a mark or marks are
33burned into human skin tissue with a hot iron or other instrument,
34with the intention of leaving a permanent scar.

35(g) “Client” means an individual upon whom a practitioner
36performs body art.

37(h) “Decontamination and sterilization area” means a room, or
38specific section of a room, that is set apart and used only to
39decontaminate and sterilize instruments.

40(i) “Department” means the State Department of Public Health.

P4    1(j) “Decontamination” means the use of physical or chemical
2means to remove, inactivate, or destroy bloodborne pathogens on
3a surface or item to the point where the pathogens are no longer
4capable of transmitting infectious particles and the surface or item
5is rendered safe for handling, use, or disposal.

6(k) “Disinfectant” means a product that is registered by the
7federal Environmental Protection Agency and the Department of
8Pesticide Regulation, as indicated on the label, to reduce or
9eliminate the presence of disease-causing microorganisms,
10including human immunodeficiency virus (HIV) and hepatitis B
11virus (HBV) for use in decontaminating work surfaces.

12(l) “Enforcement officer” means all local health officers,
13directors of environmental health, and duly authorized registered
14environmental health specialists and environmental health specialist
15trainees.

16(m) “Hand hygiene” means either of the following:

17(1) Thoroughly washing all surfaces of the hands and under the
18fingernails with soap and warm water.

19(2) In the absence of contamination with blood or other bodily
20fluids, or obvious soiling, applying an antiseptic solution to all the
21surfaces of the hands and underneath the fingernails.

22(n) “Instrument” means a nonmedical application device used
23in performing body art, including, but not limited to, needles,
24needle bars, needle tubes, forceps, hemostats, tweezers, razors, or
25razor blades.

26(o) “Local enforcement agency” means the local health agency
27of the county, city, or city and county. In jurisdictions where the
28local health agency and the environmental health agency are
29separate departments, the jurisdiction shall specify which entity
30will be the local enforcement agency for purposes of this chapter.

31(p) “Mucosal surface” means the moisture-secreting membrane
32lining of all body cavities or passages that communicates with the
33exterior, including, but not limited to, the nose, mouth, vagina,
34and urethra.

35(q) “Owner” means either of the following:

36(1) The person or persons whose name or names appear on the
37health permit, business license, property deed, or rental agreement
38of the body art facility.

P5    1(2) A person, acting as a principal of a corporation or
2partnership, who employs practitioners to perform body art or
3other activity regulated by this chapter.

4(r) “Permanent cosmetics” means the application of pigments
5in human skin tissue for the purpose of permanently changing the
6color or other appearance of the skin. This includes, but is not
7limited to, permanent eyeliner, eyebrow, or lip color.

8(s) “Potable water” means water that complies with the standards
9for transient noncommunity water systems pursuant to the
10California Safe Drinking Water Act (Chapter 4 (commencing with
11Section 116275) of Part 12).

12(t) “Practitioner” means a person who performs body art on a
13client.

14(u) “Procedure area” means a room, or designated portion of a
15room, that is set apart and only used to perform body art.

16(v) “Procedure site” means the area or location on the human
17body selected for the placement of body art.

18(w) “Sharps waste” has the same meaning as that term is defined
19in Section 117755.

20(x) “Sponsor” means an individual or business entity, including
21an event coordinator or manager, responsible for the organization
22of a convention, trade show, or other temporary event that includes
23a body art demonstration booth. A sponsor may also be a body art
24practitioner.

25(y) “Sterilization” means the complete destruction of all
26microbial life forms, including spores.

27(z) “Tattooing” means the insertion of pigment in human skin
28tissue by piercing with a needle.

29(aa) “Vehicle” means a vehicle that has been fitted or designed
30to perform body art.

31(ab) “Workstation” means the area within a procedure area
32where a practitioner performs body art. The workstation includes,
33but is not limited to, the client chair or table, counter, mayo stand,
34instrument tray, storage drawer, and practitioner’s chair.

35

SEC. 3.  

Section 119303 of the Health and Safety Code is
36amended to read:

37

119303.  

(a) Prior to the performance of body art, the client
38shall read, complete, and sign an informed consent form that shall
39include, but not be limited to, all of the following information:

40(1) A description of the procedure.

P6    1(2) A description of what the client should expect following the
2procedure, including suggested care and any medical complications
3that may occur as a result of the procedure.

4(3) A statement regarding the permanent nature of body art.

5(4) Postprocedure instructions that include all of the following:

6(A) Information on the care of the procedure site.

7(B) Restrictions on physical activities such as bathing,
8recreational water activities, gardening, or contact with animals,
9and the duration of the restrictions.

10(C) Signs and symptoms of infection, including, but not limited
11to, redness, swelling, tenderness of the procedure site, red streaks
12going from the procedure site towards the heart, elevated body
13temperature, or purulent drainage from the procedure site.

14(D) Signs and symptoms that indicate the need to seek medical
15care.

16(b) Prior to the performance of body art, the client shall receive,
17complete, and sign a questionnaire that includes all of the following
18information:

19(1) Whether the client may be pregnant.

20(2) Whether the client has a history of herpes infection at the
21proposed procedure site, diabetes, allergic reactions to latex or
22antibiotics, hemophilia or other bleeding disorder, or cardiac valve
23disease.

24(3) Whether the client has a history of medication use or is
25currently using medication, including being prescribed antibiotics
26prior to dental or surgical procedures.

27(4) Other risk factors for bloodborne pathogen exposure.

begin delete

28(c) The questionnaire and all responses shall be considered
29confidential information. The body art facility shall maintain the
30privacy of the information and shall not sell, share, or transfer the
31information. A body art facility shall comply with all state and
32federal laws with respect to the protection of a client’s personally
33identifiable information, including, but not limited to, medical
34information, and shall be subject to existing penalties for violation
35of applicable laws. The body art facility shall shred any confidential
36medical information after two years from performing the body art
37procedure on the client.

end delete
begin insert

38(c) All information gathered from the client that is personal
39medical information and that is subject to the federal Health
40Insurance Portability and Accountability Act of 1996 (HIPAA) or
P7    1similar state laws shall be maintained or disposed of in compliance
2with those provisions.

end insert
3

SEC. 4.  

Section 119306 of the Health and Safety Code is
4amended to read:

5

119306.  

(a) A person shall not perform body artbegin delete ifend deletebegin insert at any
6location other than a permitted permanent or temporary body art
7facility.end insert

8begin insert(b)end insertbegin insertend insertbegin insertA person shall not perform body art ifend insert he or she is not
9registered with the local enforcement agency.

begin delete

10(b)

end delete

11begin insert(c)end insert As a condition of registration, the applicant shall provide all
12of the following:

13(1) Evidence of current hepatitis B vaccination, including
14applicable boosters, unless the practitioner can demonstrate
15hepatitis B immunity or has complied with current federal OSHA
16hepatitis B vaccination declination requirements.

17(2) Evidence of completion of OSHA Bloodborne Pathogen
18Training consistent with Section 119307 and pursuant to paragraph
19(2) of subdivision (g) of Section 5193 of Title 8 of the California
20Code of Regulations or its successor.

21(3) Proof that he or she is 18 years of age or older.

22(4) Self-certification of, knowledge of, and commitment to meet
23state law and relevant local regulations pertaining to body art
24safety.

begin delete

25(5) For first-time registrants, documentation evidencing a
26minimum of six months of related experience. The local
27enforcement agency may require documentation that includes, but
28is not limited to, dates, type, and location of work, and the name
29and contact information of the registrant’s supervisor or
30supervisors.

end delete
begin delete

31(6)

end delete

32begin insert(5)end insert His or her business address and the address at which he or
33she will perform any activity regulated by this chapter.

begin delete

34(7)

end delete

35begin insert(6)end insert Payment of a registration fee directly to the local
36enforcement agency. The local enforcement agency shall set the
37fee at an amount not to exceed the amount necessary but that is
38sufficient to cover the actual costs of administering the program.

begin delete

39(c)

end delete

P8    1begin insert(d)end insert A practitioner shall display, in a place readily visible to the
2public at the body art facility where the practitioner is performing
3body art, the certificate confirming registration with the local
4enforcement agency in the jurisdiction in which that practice is
5conducted.

begin delete

6(d)

end delete

7begin insert(e)end insert A valid and current registration issued by a local enforcement
8agency shall be valid in any other jurisdiction for no more than
9five consecutive days, or 15 days total, in any one calendar year.

begin delete

10(e)

end delete

11begin insert(f)end insert Practitioner registration shall be renewed annually by a
12process to be determined by the local enforcement agency.

begin delete

13(f)

end delete

14begin insert(g)end insert A practitioner shall obtain all necessary permits to conduct
15business, including, but not limited to, being registered with the
16local enforcement agency. In addition to the penalties available
17pursuant to Article 6 (commencing with Section 119320), a
18practitioner who violates this subdivision shall be subject to
19suspension and a penalty not to exceed three times the cost of
20 registration.

21

SEC. 5.  

Section 119312 of the Health and Safety Code is
22amended to read:

23

119312.  

(a) A body art facility shall not conduct business
24without a valid health permit.

25(b) The application for a health permit for a body art facility
26shall include all of the following:

27(1) A copy of the facility’s infection prevention control plan,
28as required by Section 119313.

29(2) A fee, as set by the local enforcement agency at an amount
30not to exceed the amount necessary but that is sufficient to cover
31the actual costs of administration of the program. Fees established
32by this section shall be used exclusively in support of activities
33pursuant to this chapter.

34(c) The local enforcement agency shall issue a health permit
35after an investigation has determined that the proposed body art
36facility and its method of operation meets the specifications of the
37approved plans or conforms to the requirements of this article.

38(d) A health permit is valid only for the location of the facility
39and the time period indicated on the permit and may not be
40transferred to another owner or facility.

P9    1(e) The health permit shall be posted in a conspicuous place at
2the body art facility. Certificates of registration for all practitioners
3performing body art in that facility shall also be prominently
4displayed either near the health permit or at the individual
5practitioner’s procedure area if each practitioner has a designated
6area.

7(f) A person proposing to construct a practice site or mobile
8practice site, other than a temporary body art event booth, shall
9submit plans to the Plan Review Unit of the local enforcement
10agency. The plans shall be approved in advance of the issuance of
11a building, plumbing, or electrical permit. All required corrections
12must be made and the body art facility approved to open before
13body art can be performed in the facility.

14(g) Health permits shall be renewed annually through a process
15to be determined by the local enforcement agency.

begin insert

16(h) The county may suspend or revoke the permit of a body art
17facility if a person who does not possess a valid practitioner
18registration is allowed to perform body art.

end insert
begin delete

19(h)

end delete

20begin insert(i)end insert An owner who operates a body art facility shall obtain all
21necessary permits to conduct business, including, but not limited
22to, a permit issued by a local enforcement agency. In addition to
23the penalties available pursuant to Article 6 (commencing with
24Section 119320), an owner who violates this subdivision shall be
25subject to the closure of the facility and a penalty not to exceed
26three times the cost of the permit.

27

SEC. 6.  

Section 119314 of the Health and Safety Code is
28amended to read:

29

119314.  

(a) With the exception of a temporary demonstration
30booth and a mobile site, as specified in Sections 119317 and
31119318, a body art facility shall comply with all of the following:

32(1) Have floors, walls, andbegin delete ceilings thatend deletebegin insert ceilings.end insert

33begin insert(2)end insertbegin insertend insertbegin insertHave floors and walls thatend insert are smooth,begin insert nonabsorbent,end insert free
34of open holes, and washable.

begin delete

35(2)

end delete

36begin insert(3)end insert Be free of insect and rodent infestation.

begin delete

37(3)

end delete

38begin insert(4)end insert Be separate from any residential areas used for sleeping,
39bathing, or meal preparation. A body art facility associated with
40a residential dwelling shall have a separate entrance and toilet
P10   1facility, and shall not have a door allowing direct access between
2the body art facility and the residential dwelling.

begin insert

3(5) Have adequate toilet facilities, in accordance with the
4specifications of the State Building Standards Code, local building
5standard codes, and any other local ordinance. The sink shall be
6supplied with hot and cold running water, containerized liquid
7soap, and single-use paper towels that are dispensed from a
8wall-mounted, touchless dispenser.

end insert

9(b) Procedure areas in a body art facility shall meet all of the
10following standards:

11(1) Be equipped with a light source that provides adequate light
12at the procedure area.

13(2) Be separated, by a wall or ceiling-to-floor partition, from
14nail and hair activities.

begin insert

15(3) Be separated from all business not related to body art, at
16the discretion of the local enforcement agency.

end insert
begin delete

17(3)

end delete

18begin insert(4)end insert Be equipped with a sink supplied with hot and cold running
19water, containerized liquid soap, and single-use paper towels that
20are dispensed from a wall-mounted, touchless dispenser that is
21accessible to the practitioner.

22(c) Decontamination and sanitation areas within a body art
23facility shall meet all of the following requirements:

24(1) Be separated from procedure areas by a space of at least five
25feet or by a cleanable barrier.

26(2) Be equipped with a sink, hot and cold running water,
27begin insert containerizedend insert liquid soap in a wall-mounted dispenser, and
28single-use paper towels dispensed from a wall-mounted, touchless
29dispenser that is readily accessible to the practitioner.

30(d) Each procedure areabegin delete and decontamination and sterilization
31areaend delete
shall have lined waste containers.

32(e) Each procedure area and decontamination and sterilization
33area shall have a container for the disposal of sharps waste that
34meets the following requirements:

35(1) The sharps waste container shall be portable, if portability
36is necessary to ensure that the sharps waste container is within
37arm’s reach of the practitioner.

38(2) The sharps waste container shall be labeled with the words
39“sharps waste” or with the international biohazard symbol and the
40word “BIOHAZARD.”

P11   1(3) All sharps waste produced during the process of tattooing,
2body piercing, or the application of permanent cosmetics shall be
3disposed by either of the following methods:

4(A) Removal and disposal by a company, or removal and
5transportation through a mail-back system approved by the
6department pursuant to subdivision (b) of Section 118245.

7(B) As solid waste, after being disinfected by a method approved
8by the department pursuant to paragraph (3) of subdivision (a) of
9Section 118215.

10(f) No animals shall be allowed in the procedure area or the
11decontamination and sterilization areabegin insert except service animals, as
12defined by the federal Americans with Disabilities Actend insert
.

13

SEC. 7.  

Section 119315 of the Health and Safety Code is
14amended to read:

15

119315.  

A body art facility shall conform to the following
16sterilization procedures:

17(a) Clean instruments to be sterilized shall first be sealed in
18peel-packs that contain either a sterilizer indicator or internal
19temperature indicator. The outside of the pack shall be labeled
20with the name of the instrument, the date sterilized, and the initials
21of the person operating the sterilizing equipmentbegin insert unless instruments
22are being sterilized for immediate useend insert
.

23(b) Sterilizers shall be loaded, operated, decontaminted, and
24maintained according to manufacturer’s directions, and shall meet
25all of the following standards:

26(1) Only equipment manufactured for the sterilization of medical
27instruments shall be used.

28(2) Sterilization equipment shall be tested using a commercial
29biological indicator monitoring system after the initial installation,
30after any major repair, and at least once per month. The expiration
31date of the monitor shall be checked prior to each use.

32(3) Each sterilization load shall be monitored with mechanical
33indicators for time, temperature, pressure, and, at a minimum,
34Class V integrators. Each individual sterilization pack shall have
35an indicator.

36(4) Biological indicator monitoring test results shall be recorded
37in a log that shall be kept on site for two years after the date of the
38results.

39(5) A written log of each sterilization cycle shall be retained on
40site for two years and shall include all of the following information:

P12   1(A) The date of the load.

2(B) A list of the contents of the load.

3(C) The exposure time and temperature.

4(D) The results of the Class V integrator.

5(E) For cycles where the results of the biological indicator
6monitoring test are positive, how the items were cleaned, and proof
7of a negative test before reuse.

8(c) Clean instruments and sterilized instrument packs shall be
9placed in clean, dry, labeled containers, or stored in a labeled
10cabinet that is protected from dust and moisture.

11(d) Sterilized instruments shall be stored in the intact peel-packs
12or in the sterilization equipment cartridge until time of use.

13(e) Sterile instrument packs shall be evaluated at the time of
14storage and before use. If the integrity of a pack is compromised,
15including, but not limited to, cases where the pack is torn,
16punctured, wet, or displaying any evidence of moisture
17contamination, the pack shall be discarded or reprocessed before
18use.

19(f) A body art facility that does not afford access to a
20decontamination and sterilization area that meets the standards of
21subdivision (c) of Section 119314 or that does not have sterilization
22equipment shall use only purchased disposable, single-use,
23presterilized instruments. In place of the requirements for
24maintaining sterilization records, the following records shall be
25kept and maintained for a minimum of 90 days following the use
26of the instruments at the site of practice for the purpose of verifying
27the use of disposable, single-use, presterilized instruments:

28(1) A record of purchase and use of all single-use instruments.

29(2) A log of all procedures, including the names of the
30practitioner and client and the date of the procedure.

31

SEC. 8.  

Section 119318 of the Health and Safety Code is
32amended to read:

33

119318.  

(a) The sponsor shall obtain all necessary permits to
34conduct business in the jurisdiction where the event will be held,
35including, but not limited to, valid permits issued by a local
36enforcement agency. A local enforcement agency may establish
37a fee not to exceed the amount necessary, but that is sufficient to
38cover, the actual costs of the administration of this section. In
39addition to the penalties available pursuant to Article 6
40(commencing with Section 119320), a sponsor who violates this
P13   1subdivision shall be subject to closure of the temporary body art
2event and a penalty not to exceed three times the cost of the permit.

3(b) The sponsor of a temporary body art event shall be
4responsible for ensuring the availability of support facilities and
5supplies for practitioners and vendors, including, but not limited
6to:

7(1) Access to a potable water supply.

8(2) Restrooms that have flush toilets supplied with toilet paper,
9and hand wash sinks supplied with hot and cold potable running
10water, soap, and single-use paper towels to which practitioners
11have direct access.

12(3) Sharps waste containers for each demonstration booth.

13(4) The use of a licensed medical waste disposal company for
14removal of all sharps waste containers used during the body art
15event.

16(5) Frequent trash pickup from demonstration booths.

begin delete

17(6) An eye wash station.

18(7)

end delete

19begin insert(6)end insert A decontamination and sterilization area that is separated
20from a procedure area by at least five feet or by a cleanable barrier.

begin delete

21(8)

end delete

22begin insert(7)end insert Adequate backup supplies that have been stored in
23compliance with subdivision (d) of Section 119315 and that can
24be purchased by practitioners, including, but not limited to:

25(A) Presterilized tattoo needles.

26(B) Presterilized needle tubes.

27(C) Presterilized piercing instruments, including, but not limited
28to, needles, receiving tubes, corks, marking tools, and forceps.

29(D) Plastic bags, barrier film, clip cord covers, and plastic wrap.

30(E) Ink cups.

31(F) Nitrile and latex gloves.

32(G) Single-use tubes of water-based and petroleum-based
33lubricants.

34(H) Absorbent dressing materials.

35(c) The name, telephone number, and directions to an emergency
36room near the temporary body art event shall be posted in a
37conspicuous location.

38(d) Each practitioner working in a booth at a temporary body
39art event shall display his or her certificate of registration, or keep
P14   1the certificate in a folder that is available for inspection upon
2request of the enforcement officer or a client.



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