BILL ANALYSIS Ó AB 1357 Page A Date of Hearing: May 12, 2015 ASSEMBLY COMMITTEE ON HEALTH Rob Bonta, Chair AB 1357 (Bloom) - As Amended April 29, 2015 SUBJECT: Children and Family Health Promotion Program. SUMMARY: Imposes a health promotion fee of $0.02 per fluid ounce on bottled sugar sweetened beverages (SSBs) and concentrates. Establishes the Children and Family Health Promotion Trust Fund (Fund) and allocates moneys from the Fund to various state departments for purposes of statewide diabetes and childhood obesity treatment and prevention activities and programs. Authorizes the Board of Equalization (BOE) to administer and collect the fee and deposit all fees, penalties, and interest collected under the law into the Fund. Contains an urgency clause to ensure that the provisions of this bill go into immediate effect upon enactment. Specifically, this bill: 1)Imposes a health impact fee on bottled sweetened beverages and concentrates in the state using the following formula: a) Two cents ($0.02) per fluid ounce on bottled sweetened AB 1357 Page B beverages; and, b) Two cents ($0.02) per fluid ounce of sweetened beverages produced from concentrate, based on the largest volume resulting from the concentrate's use according to any manufacturer's instructions. 2)Establishes the Fund within the State Treasury. Specifies the allocation of funds, by percentage, to various entities as follows: a) Fifty-one percent must be allocated to Department of Public Health (DPH), to be divided among the following activities: i) A competitive grant program to county governments, nonprofit organizations, and community based organizations seeking to invest in childhood obesity and diabetes prevention activities. Requires funding to support programs that use educational, environmental, policy, and other public health approaches to achieve all the following goals: improve access to, and consumption of, healthy and affordable foods and beverages; reduce access to, and consumption of, calorie-dense and nutrient-poor foods; encourage physical activity and decrease sedentary behavior; and, raise awareness about the importance of nutrition and physical activity in the prevention of childhood obesity and diabetes; ii) A competitive grant program for licensed clinics to invest in childhood obesity and diabetes prevention and treatment activities, children's dental programs to support program that use education, and other public health approaches that raise awareness about the importance of nutrition and physical activity; and, AB 1357 Page C iii) Dental health programs through the DPH Oral Health Program. b) Twenty-five percent of funds must be allocated to the Department of Education (CDE), to be divided among the following activities: i) A competitive grant program for school districts for educational, environmental, policy, and other public health approaches that promote physical activity, and nutrition, and ensure access to clean drinking water throughout the school day; and, ii) The CDE Farm to School Program. c) Twenty percent of funds must be allocated to the Department of Food and Agriculture (DFA), for the purposes of supporting nutritious food incentives programs through the DFA Office of Farm to Fork and administering a competitive grant program to support producers of fresh fruits and vegetables and other specialty crops. d) Four percent of funds must be allocated to the Department of Health Care Services (DHCS) Expanded Access to Primary Care, Rural Health Services Development, Seasonal Agricultural Migratory Workers, and Indian Health programs. Requires the funds to be used to support clinic-based obesity and diabetes prevention and related disease management. 3)Requires DPH to develop an application and process for the grant programs established pursuant to this section. AB 1357 Page D 4)Requires that allocation of money from the fund give priority to communities exhibiting high prevalence of type 2 diabetes, as reported by the California Health Interview Survey (CHIS), using the most current survey data available. 5)Requires that funds in the Fund be expended only for purposes specified and to supplement existing levels of service. Prohibits any moneys from the Fund from supplanting current federal, state, or local funding for existing levels of service. 6)Authorizes the State Public Health Officer, the Secretary of DFA, the Director of DHCS, and the Superintendent of Public Instruction to coordinate to make rules and regulations to implement the fund allocation. 7)Requires the State Auditor to conduct periodic audits, starting no later than 24 months after the bill's effective date, to ensure annual allocation to individual programs is awarded in a timely fashion consistent with the requirements of this chapter. 8)Requires DPH, beginning July 1, 2016, to appoint an advisory committee to provide input regarding the implementation of the program. Specifies that the advisory committee must be a purely advisory body and must have no final decision making authority in implementing this bill. Requires the advisory committee to submit to the Legislature an annual report regarding the process and outcome performance of the Fund. Specifies that the committee will be composed of at least AB 1357 Page E seven members as follows: a) One member each from DPH, DFA, DHCS, and CDE; and, b) One appointee each from the Governor, the Speaker of the Assembly and the President pro Tempore of the Senate. Requires the appointees to have expertise in childhood obesity and diabetes prevention, experience in researching public health issues or evaluating related public health programs, or experience with community-based chronic disease prevention organizations. 9)Requires, by July 1, 2016, DPH, in consultation with DHCS, CDE, and DFA to prepare an annual budget for the Children and Family Health Promotion Program, including anticipated revenues and costs of implementing the program, a recommended funding level to operate the program, and the amount of fees collected by the state. Requires DPH to adopt final program budget by October 1 of each year. Creates the Children and Family Health Promotion Administration Account, within the Fund, for the purposed of reimbursing DPH for administrative and implementation costs of the program. 10)Requires the BOE to administer and collect the fees under the Fee Collection Procedures Law. Allows the BOE to adopt regulations and prescribe reporting requirements necessary to implement the fee, including information regarding the total amount of bottled sweetened beverage and concentrate sold, and the amount of fee due. 11)Requires distributors required to pay the fees imposed to register with the BOE. AB 1357 Page F 12)Requires fee payers to file with BOE a return on or before the last day of the calendar month following the calendar quarter, together with a remittance for the amount of fee due for that period. 13)Provides several definitions including , but not limited to, the following: a) A "sugar-sweetened beverage" means a nonalcoholic beverage, carbonated or not, that contains added caloric sweetener. Specifies that SSBs do not include: i) Beverages sweetened with noncaloric sweeteners; ii) Beverages sweetened with 100% natural fruit or vegetable juice; iii) Beverages in which whole milk (including plant based milk-substitutes) is the primary or first-listed ingredient; iv) Beverages with fewer than five grams of added sugar or other caloric sweeteners per 12 ounces; v) Coffee or tea without added caloric sweetener; vi) Infant formula; AB 1357 Page G vii) Beverages for medical use; and, viii) Water without any caloric sweetener. EXISTING LAW: 1)Establishes DPH to protect and improve the health of communities through education, promotion of healthy lifestyles, and research for disease and injury prevention. 2)Establishes restrictions on the sale of certain beverages in schools by placing restrictions on the types of beverages allowed to be sold in elementary, middle, and junior high schools and high schools. 3)Establishes the BOE to collect California state sales and use tax, as well as fuel, alcohol, and tobacco taxes and fees that provide revenue for state government and essential funding for counties, cities, and special districts. 4)Imposes sales tax on the retail sale of tangible personal property. Imposes use tax on the storage, use, or other consumption of tangible personal property from any retailer. Requires the sale or use tax to be computed on the retailer's gross receipts or sales price, respectively, unless the law provides a specific exemption or exclusion. Provides an exemption for the sale of, and the storage, use, or other consumption of, food products for human consumption including, in part, all fruit juices, vegetable juices, and other beverages, including bottled water, but not to include AB 1357 Page H carbonated beverages. FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee. COMMENTS: 1)PURPOSE OF THIS BILL. According to the author, this bill would establish the Children and Family Health Promotion Program. The program will administer a competitive grant process to provide counties, nonprofit organizations, community-based organizations, and licensed clinics to fund childhood diabetes and obesity prevention activities and oral health promotion programs. The program will also fund existing programs designed to increase access to California-grown healthy and fresh foods, encourage increased physical education in California's public schools, and ensure access to clean drinking water. The revenues from this bill will be used to help diminish the human and economic costs of diabetes, obesity, heart disease, and dental disease in California. The author asserts that diabetes alone adds an extra $1.6 billion every year to state hospitalization costs with the attendant increased cost in all of our public health programs - money which would be better invested in preventive health and education. Although the number of Californians with diabetes has increased significantly over the past decade, DPH received 22% less federal funding for diabetes prevention in fiscal year 2013-14. At a funding level of $0.03 per capita, California has the lowest per capita funding for diabetes prevention in the nation. The author states that California needs to step up its efforts to combat and prevent childhood obesity and diabetes and that there is a great need for a new program to AB 1357 Page I fund more effective local prevention and treatment programs. 2)Obesity, DIABETES, and other chronic diseases. According to the Centers for Disease Control and Prevention, more than one-third of U.S. adults are obese, and approximately 12.5 million children and adolescents ages two to 19 years are obese. Research indicates a tripling in the youth obesity rate over the past three decades. While this increase has stabilized between the years 2005 and 2010, in 2010, 38% of public school children were overweight and obese. Overweight youth face increased risks for many serious detrimental health conditions that do not commonly occur during childhood, including high cholesterol and type 2 diabetes. Additionally, more than 80% of obese adolescents remain obese as adults. Obese children and teenagers also remain at greater risk for developing serious chronic diseases including type 2 diabetes, heart disease, high blood pressure, cancer and other health conditions including asthma, sleep apnea, and psychosocial effects such as decreased self-esteem. In one large study, 61% of overweight five to 10 year-olds already had at least one risk factor for heart disease, and 26% had two or more risk factors. An overweight adolescent has a 70% chance of being overweight or obese as an adult. According to the September 2014 Burden of Diabetes in California report by DPH, over 2.3 million California adults report having been diagnosed with diabetes, representing one out of every 12 adult Californians. The vast majority of diabetes cases in California are type 2, representing 1.9 million adults. The prevalence increases with age-one out of every six adult Californians aged 65 and above have type 2 diabetes-and is higher among ethnic/racial minorities and Californians with low education attainment and/or family income. Compared with non-Hispanic whites, Hispanics and African Americans have twice the prevalence of type 2 diabetes and are twice as likely to die from their disease. Diabetes is the seventh leading cause of death in California, and determined to be the underlying cause of death in almost 8,000 AB 1357 Page J people each year. As diabetes is a contributing factor to many deaths from heart disease and stroke, diabetes may be under-represented as a contributing cause of death. 3)THE ECONOMIC BURDEN. The last decade has witnessed a 32% rise in diabetes prevalence, affecting some 3.9 million people and costing upwards of $24 billion per year. Overall health care spending on obesity continues to significantly burden the nation, however, and the most recent research data available estimate obesity-related health care costs at nearly $150 billion annually. According to the National Conference on State Legislatures, taxpayers fund about half of these costs, at approximately $60 billion, through Medicare and Medicaid. Recent research indicates that if obesity rates are reduced by as little as 5%, health care savings could exceed $29 billion. Childhood obesity also poses a national security challenge, as obesity has become one of the most common disqualifiers for military service; affecting 25% of those who apply to serve. The medical costs and associated costs of diabetes jumped to $245 billion in 2012, meaning that the diabetes toll on the economy has increased by more than 40% since 2007, according to a recent report from the American Diabetes Association. The 2007 figures were $116 billion for diabetes and the indirect costs (disability, work loss, premature mortality) were $58 billion. According to the California Diabetes Program total health care and related costs for the treatment of diabetes in California are about $24.5 billion each year. Direct medical costs (e.g., hospitalizations, medical care, treatment, supplies) account for about $18.7 billion, with the other $5.8 billion including indirect costs such as disability payments, time lost from work, and premature death. The average annual treatment cost per case for diagnosed diabetes in the U.S. was nearly $10,000 in 2007. The economic burden of diabetes and prediabetes on the average person is estimated to be over $700 for every man, woman, and child - representing AB 1357 Page K a hidden 'tax' paid by all through higher insurance premiums<1>. 4)CAUSE, CORRELATION, AND RISK. It is very difficult to scientifically prove a direct causal relationship between diet and disease in humans. In laboratory animal studies, a single variable can be changed while all others are held constant to determine a direct cause-and-effect relationship. It is nearly impossible to exert the same level of control in human dietary studies. However, while it may be impossible to completely eliminate alternate hypotheses, a causal relationship between the intake of added sugar and obesity is supported by strong epidemiological evidence. A meta-analysis published in the American Journal of Clinical Nutrition looked at 30 studies of sugary drink consumption published from 1966 to 2005 and found that sugary drink consumption was associated with weight gain and obesity. Another study concluded that sugary drinks are likely to account for at least 20% of the weight gained by Americans between 1977 and 2007. Numerous studies indicate that higher consumption of sugary drinks is associated with higher risk of weight gain and also with higher risk of developing type 2 diabetes. 5)EFFORTS TO REDUCE CALORIE CONSUMPTION. Along with increasing physical activity and providing nutritious food, reducing calories from all sources is a necessary component to reduce obesity and associated chronic health conditions. Research shows that people generally underestimate the number of calories in the foods they consume. A recent study asking participants to estimate the caloric content of nine restaurant entrées found that 90% underestimated the caloric content of less healthy items by an average of more than 600 calories. Controlling the intake of added sugars represents an important component of lifestyle management for weight control and maintenance. A recent report by the Institute of Medicine identified sugary drinks as the single largest --------------------------- <1> March 2012 fact sheet. California Diabetes Program, Diabetes Information Resource Center. www.caldiabetes.org AB 1357 Page L contributor of calories and added sugars to the U.S. diet. The 2010 Dietary Guidelines for Americans, published every five years jointly by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture, admonished individuals to reduce consumption of SSBs, recommended that adult Americans should eat a maximum of 10% of their daily calories from added sugars. In March 2015, the World Health Organization's (WHO) new Guideline: Sugars Intake for Adults and Children recommends reduced intake of sugar throughout the life course. In both adults and children, the intake of sugar should be reduced to less than 10% of total energy intake. For a person who consumes 2,000 calories per day that means intake of added sugars should be limited to less than 30 grams (or two tablespoons). WHO found that a further reduction to below 5% of total energy intake would provide additional health benefits. 6)POLICY INTERVENTIONS AND UNHEALTHY PRODUCTS. Mounting evidence suggests that effectively curbing the obesity epidemic and reversing the upward trend will require comprehensive approaches across sectors involving public and private stakeholders at the local, state, and federal level. Many believe that the comprehensive approach must be similar to policy efforts previously employed to improve motor vehicle safety or curb usage of alcohol or tobacco. After passage of the California Tobacco Tax and Health Promotion Act of 1988 (Proposition 99), the state created the California Tobacco Control Program (CTCP), implemented a variety of grassroots efforts to educate consumers about the harmful effects of tobacco use, and passed several anti-tobacco laws, such as local and statewide policies to limit smoking in public places, prohibit the incidence of tobacco sales to minors, and restrictions on tobacco advertising; all designed to address smoking prevalence. California's early efforts have shaped best practices for comprehensive tobacco control efforts throughout the nation and the world. According to CTCP, these efforts have so far saved more than one million lives and over $86 billion in health care costs. While tobacco use continues AB 1357 Page M to be pervasive and costly, California has been successful at significantly curbing the burden of tobacco use on California families, our health care system and our economy. Since the early 1980s, a growing number of economists have examined the impact of the price of alcoholic beverages on alcohol consumption. Studies investigating such a relationship found that alcohol prices were one factor influencing alcohol consumption among youth and young adults. Other studies determined that increases in the total price of alcohol can reduce drinking and driving and its consequences among all age groups; lower the frequency of diseases, injuries, and deaths related to alcohol use and abuse; and reduce alcohol-related violence and other crime. A large body of research supports the view that increases in the monetary prices of alcoholic beverages, which can be achieved by raising federal, state, and local alcohol taxes, significantly reduce alcohol consumption<2>. 7)POTENTIAL EFFECT OF SSB FEE. Over the past decade, states and localities have begun to consider taxing SSBs in order to generate revenue, reduce consumption of unhealthy beverages, and promote public health. According to a 2009 issue brief by the Robert Wood Johnson Foundation, emerging studies suggest that small taxes on SSBs are unlikely to affect obesity rates, but they can generate revenue that states can invest in improving public health. In addition, while there is only limited research on the impact of taxes on SSB consumption rates and related weight outcomes, existing research on the impact of prices on food-purchasing behaviors in general suggest that substantive taxes on SSBs could significantly affect consumption patterns and thereby have an impact on overweight and obesity rates. --------------------------- <2> Chaloupka FJ, Grossman M, and Saffer H. 2002. The Effects of Price on Alcohol Consumption and Alcohol-Related Problems Alcohol Res Health. 2002;26(1):22-34. AB 1357 Page N In October 2013, Mexican President Enrique Peña Nieto approved a 1 peso (about $0.07) tax per liter of SSB, which national health experts saw as one antidote to Mexico's alarming diabetes rates. The measure took effect January 1, 2014. A year later, preliminary data suggest consumption rates are falling, though it's too early to say precisely how much. Mexico's National Institute of Public Health earliest results suggest that in the first three months of 2014, purchases of sugary drinks dropped by 10% from the same period in 2013. Meanwhile purchases of untaxed drinks, like 100% fruit juice and milk, went up 7%, and purchases of bottled water went up 13%. 8)RECENT LOCAL EFFORTS. In November 2014, Berkeley, California became the first city in the nation to adopt a soda tax after 30 other cities and states around the country failed. Its Measure D levied a penny-per-ounce tax on sugar-sweetened drinks. Its revenues were not dedicated to any particular purpose, therefore needing only a simple majority vote to pass. It won the support of 75% of voters. In the same election, a similar measure in San Francisco failed, however. San Francisco's Proposition E would have levied $0.02 per-ounce tax, and it needed two-thirds of the votes to pass because it would have directed revenue to physical education and nutrition programs for children. Proposition E failed to secure two-thirds support, and only received a simple majority, 55%, of votes. The Berkeley Measure D soda tax went into effect on January 1, 2015. 9)SUPPORT. The American Heart Association, cosponsor of this bill, states that the adverse health effects of the AB 1357 Page O overconsumption of SSBs are harming our communities, and its effects pose a significant economic burden on our state that requires urgent action. They further state that soda and other SSBs are the number one source of added sugar in the American diet, and are linked to increased risk of diabetes and other serious diseases such as heart and liver disease, obesity, and tooth decay. The Center for Science in the Public Interest and other supporters state that definitive scientific studies have concluded that SSB intake is a major cause of rising obesity rates. Most people consume nearly 300 more calories per day than 30 years ago and 43% of that caloric increase comes from the consumption of SSBs. Latino Coalition for a Healthy California, a cosponsor of this bill, states that the revenue generated by this fee will enable the state to improve access to healthy foods and invest in diabetes-related healthcare services and prevention in communities that are disproportionately impacted by type 2 diabetes and other diseases related to high sugar consumption. 10)OPPOSITION. The California League of Food Processors states that they understand and share the concerns about the nationwide problem with obesity, but do not believe that this bill is the right policy approach. The personal decision to purchase and consume a SSB should not be regulated by the Legislature through the imposition of new fees or taxes. Californians for Food and Beverage Choice state that singling out one group of products is discriminatory and will not reduce obesity or diabetes. Obesity and diabetes are complex health issues that have myriad contributing factors including genetics, physical activity, and calorie intake from all sources - not just beverages. As a result, it is unfair and inaccurate to portray SSBs as the main culprit. It needs to be made clear that obesity and related diseases, like diabetes, have multiple risk factors, including diet, genetics, age, and stress. Dealing with these health issues is more complicated than simply taxing a sub-set of beverages. The California-Nevada Beverage Association and others state AB 1357 Page P that targeting a specific industry to pay for a problem that has multiple causes is short sighted and will impede economic growth and eliminate jobs in that industry. The business community consistently maintains that if a fee or tax is necessary, it should only be temporary and broad based so that the impact is minimized as it is shared by all instead of an individual business or industry. 11)RELATED LEGISLATION. a) AB 572 (Beth Gaines) requires DPH to create a detailed diabetes action plan for the state, and to report the results of the plan to the Legislature biennially. Requirements include the development of a detailed budget blueprint identifying needs, costs, and resources required to implement the plan and a proposed budget for each action step, as well as policy recommendations for the prevention and treatment of diabetes. AB 572 is pending in the Assembly Appropriations Committee. b) SB 203 (Monning), establishes the Sugar-Sweetened Beverages Safety Warning Act, to be administered by DPH, and requires a safety warning on all sealed SSB containers, as specified. Requires the warning label to be posted in a place that is easily visible at the point-of-purchase of an establishment where a beverage container is not filled by the consumer. SB 203 failed passage in the Senate Health Committee. c) SCR 34 (Monning), proclaims the month of September 2015, and each year thereafter, as Childhood Obesity Awareness Month, and expresses the Legislature's support of various programs that work to reduce obesity among children, including those that increase access to affordable healthful foods and beverages and provide less access to high-calorie foods and SSBs. SCR 34 was approved by the AB 1357 Page Q Senate on April 16, 2015 with a vote of 29-4, and is currently pending action in the Assembly. 12)PREVIOUS LEGISLATION. a) SB 1000 (Monning) of 2014 would have established the Sugar-Sweetened Beverages Safety Warning Act, to be administered by DPH, and required a safety warning on all sealed SSB containers. Would have required the warning label to be posted in a place that is easily visible at the point-of-purchase of an establishment where a beverage container is not filled by the consumer. SB 1000 failed passage in the Assembly Health Committee. b) SB 622 (Monning) of 2013 would have imposed $0.01 per fluid ounce tax on bottled SSBs and concentrates. SB 622 was held on the Suspense File in the Senate Appropriations Committee. c) AB 669 (Monning) of 2011 was similar to SB 622. AB 669 was held in the Assembly Revenue and Taxation Committee. d) AB 2100 (Coto) of 2010 would have imposed a $0.01 per teaspoon of added sweetener tax on SSBs and concentrates. AB 2100 was held in the Assembly Revenue and Taxation Committee. e) SB 1210 (Florez) of 2010, a similar measure to AB 2100, was placed on the former Senate Revenue and Taxation Committee's Suspense File. AB 1357 Page R f) SB 1520 (Ortiz) of 2002 would have imposed an excise tax upon every distributor, manufacturer, or wholesale dealer at a rate of $2 per gallon of soft drink syrup or simple syrup, $0.21 per gallon of bottled soft drinks, and $0.21 per gallon of soft drink produced from powder. The soda tax provisions were removed from the April 29, 2002, version of the bill. g) AB 105 (Moore) of 1983 would have imposed an excise tax on the distribution of nonalcoholic carbonated beverages, except carbonated water and carbonated fruit juice, at the rate of $0.07 per gallon. The provisions of that bill also included an excise tax on the distribution of nonalcoholic carbonated beverage syrup at the rate of $0.50 per gallon of liquid syrup. AB 105 also died in the Assembly Revenue and Taxation Committee. 13)SUGGESTED AMENDMENTS. a) Technical amendment. On page 11, line 4, the following sentence should be corrected as follows: Section 104895.51(i) In establishing these regulations, thedepartmentdepartments shall give particular consideration to reducing the prevalence of diabetes in at-risk communities, asidentified by data from the CHIS. b) Departments will need to collaborate with BOE to prepare program budget. As drafted, this bill requires DPH and the other departments to prepare an annual program budget, AB 1357 Page S including the amount of fees that have been paid to BOE. The bill should specify that BOE will also coordinate with the departments to provide the necessary information for preparing the annual budget. REGISTERED SUPPORT / OPPOSITION: Support American Heart Association / American Stroke Association (cosponsor) California Dental Association (cosponsor) Latino Coalition for a Healthy California (cosponsor) ACCESS Women's Health Justice ACT for Women and Girls AltaMed Health Services Corporation AB 1357 Page T Alturas Health American Federation of State, County and Municipal Employees, AFL-CIO Asian Americans Advancing Justice - Los Angeles Asian Law Alliance Asian Pacific Partners for Empowerment, Advocacy, and Leadership Black Women for Wellness California Alliance of Boys & Girls Clubs California Association of Environmental Health Administrators California Black Health Network AB 1357 Page U California Center for Public Health Advocacy California Chronic Care Coalition California Food Policy Advocates California Immigrant Policy Center California Latinas for Reproductive Justice California Pan-Ethnic Health Network California Partnership California Primary Care Association California Rural Indian Health Board, Inc. California Rural Legal Assistance Foundation Cal-Islanders Humanitarian Association AB 1357 Page V Center for Science in the Public Interest Central Valley Partnership for Citizenship Centro Binacional para el Desarrollo Indígena Oaxaqueño - Fresno Centro Binacional para el Desarrollo Indígena Oaxaqueño - Greenfield Centro Binacional para el Desarrollo Indígena Oaxaqueño - Los Angeles Chinese Progressive Association Coalition for Humane Immigrant Rights of Los Angeles Community Alliance with Family Farmers Community Clinic Association of Los AB 1357 Page W Angeles County Consejo de Federaciones Mexicanas County Health Executives Association of California Earth Mama Healing El Camino Children and Family Services, Inc. El Quinto Sol de America Farmer Veteran Coalition Fresno Center for New Americans Fresno Interdenominational Refugee Ministries Guam Communications Network AB 1357 Page X Having Our Say Coalition Health Officers Association of California Healthy and Active Before 5 Korean Community Center of the East Bay Korean Resource Center Latino Health Alliance Libreria del Pueblo Madera Coalition Maternal and Child Health Access Mexican American Legal Defense Fund Mid-City CAN National Council of La Raza National Hmong American Farmers AB 1357 Page Y Nile Sisters Development Initiative North County Health Services Orange County NAACP Pacific Islander Cancer Survivors Network PDI Surgery Center Prevention Institute Providence Health & Services Southern California Roots Community Health Center/Roots Community Health Alliance Roots of Change Santa Clara County Board of Supervisors San Ysidro Health Center AB 1357 Page Z Saban Community Clinic Services, Immigrant Rights, and Education Network South Asian Network SSG/Pals for Health Street Level Health Project Sustainable Economic Enterprises of Los Angeles The Council of Mexican Federations United Farm Workers Vision y Compromiso Young Invincibles AB 1357 Page A Opposition American Beverage Association Association of Food, Beverage, and Consumer Products Companies CalAsian Chamber of Commerce California Attractions and Parks Association California Chamber of Commerce California Grocers Association California League of Food Processors California Restaurant Association California Retailers Association California Right to Life Committee, Inc. AB 1357 Page B California Taxpayers Association California Teamsters Public Affairs Council California-Nevada Beverage Association Californians for Food and Beverage Choice Howard Jarvis Taxpayers Association IFA Franchising Juice Products Association Los Angeles County Business Federation National Association of Theatre Owners of California/Nevada National Federation of Independent Business AB 1357 Page C Analysis Prepared by:Dharia McGrew / HEALTH / (916) 319-2097