BILL ANALYSIS                                                                                                                                                                                                    Ó




                                                                  AB 1819
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          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)










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          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








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          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  









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          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  









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          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
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           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