BILL ANALYSIS Ó AB 1819 Page A Date of Hearing: March 25, 2014 ASSEMBLY COMMITTEE ON HUMAN SERVICES Mark Stone, Chair AB 1819 (Hall) - As Introduced: February 18, 2014 SUBJECT : Child Day Care Homes SUMMARY : Bans smoking in child day care homes. Specifically, this bill : 1)Expands the existing prohibition against smoking in a family day care home from only during the hours of operation to anytime. EXISTING LAW 1)Establishes the California Child Day Care Facilities Act (CDCFA) to provide a comprehensive, quality system for licensing child day care facilities and family day care homes to ensure that working families have access to healthy and safe child care providers and that child care programs contribute positively to a child's emotional, cognitive, and educational development, and are able to respond to and provide for the unique characteristics and needs of children. (H&S Code 1596.70 and 1596.72) 2)Defines a "family day care home" as a home that regularly provides nonmedical care, protection, and supervision for 14 or fewer children, in the provider's own home, for less than 24 hours per day. (H&S Code 1596.78) 3)Defines a "large family day care home" as a home that provides family day care for seven to 14 children, including children under 10 years of age who reside in the home. (H&S Code 1596.78(b)) 4)Defines a "small family day care home" as a home that provides family day care for eight or fewer children, including children under 10 years of age who reside in the home. (H&S Code 1596.78(c)) 5)Prohibits the smoking of tobacco in a family day care home during its hours of operation. (H&S Code 1596.795) AB 1819 Page B 6)Permits a city or county to enact or enforce an ordinance relating to smoking in a family day care home if it is more stringent than the state prohibition. (H&S Code 1596.795) 7)Requires the Department of Social Services' (DSS) Community Care Licensing Division (CCLD) to conduct an unannounced investigation in response to a complaint filed against a licensed child care home or facility within ten days of the complaint being filed. (H&S Code 1596.853(b)) 8)Prohibits the CCLD from informing the licensee of the nature of the complaint prior to the inspection. (H&S Code 1596.863(b)) FISCAL EFFECT : Unknown COMMENTS : This bill seeks to increase the safety of family day care program settings by extending the current ban on smoking while children are present to a complete ban on smoking in family day care homes, even during hours of nonoperation. The dangers of secondhand smoke : It is clear, based on numerous reports and studies, that smoking and the exposure to secondhand smoke is detrimental to a person's health, especially the health of young children. This year the Surgeon General of the United States released its 32nd report on the dangers of smoking to honor the 50th anniversary its first-ever report on the health risks associated with smoking entitled "Smoking Health Report of the Advisory Committee of the Surgeon General of the Public Health Service" in 1964. In 50th Anniversary report, the Surgeon General states that: "?smoking is now causally associated with age-related macular degeneration, diabetes, colorectal cancer, liver cancer, adverse health outcomes in cancer patients and survivors, tuberculosis, erectile dysfunction, orofacial clefts in infants, ectopic pregnancy, rheumatoid arthritis, inflammation, and impaired immune function."<1> He goes on to further state that "exposure to secondhand smoke has now been causally associated with an increased risk for --------------------------- <1> "The Health Consequences of Smoking - 50 Years of Progress." A Report of the Surgeon General. United States Public Health Service; United States Department of Health and Human Services. 2014 AB 1819 Page C stroke." Additionally, in a previous report issued by the Surgeon General in 2006, entitled "The Health Consequences of Involuntary Exposure to Tobacco Smoke," which focused on the negative health impacts of secondhand smoke exposure, it was found that secondhand smoke: is harmful and hazardous to the health of the general public and particularly dangerous to children; increases the risk of serious respiratory problems in children, such as a greater number and severity of asthma attacks and lower respiratory tract infections, and increases the risk for middle ear infections; is a known human carcinogen (cancer-causing agent); and causes lung cancer and coronary heart disease in nonsmoking adults. It specifically went on to demonstrate that efforts to accommodate for smoking and smoke-free areas are ineffective in combating the consequences of exposure to secondhand smoke: Research reviewed in this report indicates that smoke-free policies are the most economic and effective approach for providing protection from exposure to secondhand smoke. But do they provide the greatest health impact? Separating smokers and nonsmokers in the same airspace is not effective, nor is air cleaning or a greater exchange of indoor with outdoor air. Additionally, having separately ventilated areas for smoking may not offer a satisfactory solution to reducing workplace exposures. Policies prohibiting smoking in the workplace have multiple benefits. Besides reducing exposure of nonsmokers to secondhand smoke, these policies reduce tobacco use by smokers and change public attitudes about tobacco use from acceptable to unacceptable. Emerging findings on the health impacts of third hand smoke exposure : Over the last several years, research has begun to reveal the health impacts of third hand smoke. Described as the residual chemicals left on indoor surfaces as a result of smoking, it is commonly considered to be the left over residue AB 1819 Page D from secondhand smoke, which includes cancer-causing chemicals such as nicotine and benzene, toxic metals like chromium and lead, and harmful gases like carbon monoxide and ammonia. Particularly alarming is the presence and increased health risks presented by third hand smoke. In many cases, third hand smoke can remain long after smoking has stopped and become imbedded in common household items, such as carpets, curtains, tables, etc. In the case of children, especially infants and toddlers, third hand smoke presents an even greater health risk. As they explore and put their hands or toys in their mouths, they could touch, swallow or inhale compounds from third-hand smoke. Their age and early developmental stages make them more vulnerable than adults to the effects of environmental hazards due to their developing immune system, and thus, are more likely to be exposed to third hand smoke. In a report released in June 2013 by the University of California's Lawrence Berkeley National Laboratory entitled Thirdhand smoke causes DNA damage in human cells it was found that "thirdhand smoke-the noxious residue that clings to virtually all surfaces long after the secondhand smoke from a cigarette has cleared out-cause's significant genetic damage in human cells." Specifically, the research demonstrated that third hand smoke has the potential to become more damaging to a person's health than acute smoke or secondhand smoke exposure due to the interaction of residual chemicals of third hand smoke with existing indoor pollutants. Long after a person smokes, the lingering nicotine and other chemicals can become more condensed and potent, and in some cases become new pollutant compounds that are carcinogenic, thus presenting greater long-term health risks, such as uncontrolled cell growth and the formation of cancerous tumors later in life. These findings are particularly disturbing, indicating that third hand smoke cannot be eliminated by the airing out of indoor spaces or restricting exposure to secondhand smoke. Rather, the safest environment is a smoke-free environment where cigarette smoke and fumes are never present. Requiring family child care homes to be smoke free is aligned with the state's priority of providing a healthy and safe environment for children in licensed and state-supported child development programs. Monitoring of a no smoking ban : Under current law, smoking is not allowed in many community care facilities, including AB 1819 Page E licensed child care facilities and licensed children's institutions (group homes), which provides an existing example of how a no smoking ban on family child care homes could be enforced. Also available is the state's complaints process, which can serve as an effective way to enforce a no smoking ban, as it allows any person, for any reason to file a complaint, either verbally or written, against a licensed facility. For example, if a parent, when dropping of his or her child at a family child care home, or a neighbor of a family child care home provider, suspects or witnesses a family child care home provider smoking, that person can file a complaint with CCLD. Once a complaint is filed, CCLD is required to conduct an investigation into the merits of the complaint within ten days to determine if the complaint is legitimate and should be pursued further. There also exists the state's requirement to conduct regular unannounced licensing inspections once every five years. Although many consider this schedule insufficient to adequately monitor and assess whether community care and child care homes and facilities are providing for the health and safety of those under there care, it does provide another mechanism of oversight. Need for the bill: Stating the need for the bill, the author writes: AB 1819 requires licensed family day care homes to maintain a smoke free environment for the children that are under their care and protection. The measure is consistent with similar requirements in nine other states and the District of Columbia. Exposure to second and third hand smoke leads to lifelong health issues that will require continued medical attention and increased healthcare costs. This measure will have a direct impact on reducing childhood exposure to second and third hand smoke and decrease the chance of a child developing health issues related to smoking. DOUBLE REFERRAL . This bill has been double-referred. Should this bill pass out of this committee, it will be referred to the Assembly Governmental Organization Committee. AB 1819 Page F REGISTERED SUPPORT / OPPOSITION : Support California Alternative Payment Program (CAPPA) National Association of Social Workers, CA Chapter (NASW-CA) Opposition None on file Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089