BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 223|
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THIRD READING
Bill No: AB 223
Author: Ma (D), et al
Amended: 8/20/10 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 5-0, 6/9/10
AYES: Alquist, Cedillo, Leno, Negrete McLeod, Pavley
NO VOTE RECORDED: Strickland, Aanestad, Cox, Romero
SENATE APPROPRIATIONS COMMITTEE : 9-0, 6/28/10
AYES: Kehoe, Cox, Alquist, Corbett, Denham, Leno, Price,
Wolk, Yee
NO VOTE RECORDED: Walters, Wyland
ASSEMBLY FLOOR : 68-0, 1/27/10 (Consent) - See last page
for vote
SUBJECT : Safe Body Art Act
SOURCE : CA Association of Environmental Health
Administrators
Health Officers Association of California
Alliance of Professional Tattooists
Association of Professional Piercers
DIGEST : This bill enacts the Safe Body Art Act,
providing minimum statewide standards for the regulation of
persons engaged in the business of tattooing, body
piercing, and the application of permanent cosmetics,
repeals current provisions regarding these business, and
CONTINUED
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provides statewide requirements for the performance of ear
piercing with a mechanical device.
Senate Floor Amendments of 8/20/10 allow the Department of
Public Health (DPH) to promulgate regulations regarding
several areas of body art practices, which include the
Bloodborne Pathogens Exposure Control Training, the
Infection Prevention and Control Plan, body art hygiene and
sanitation procedures, ear piercing procedures, products
used in permanent cosmetics/tattooing, and facility
requirements. If DPH chooses to promulgate these
regulations, they preempt the statutes in this bill upon
adoption.
ANALYSIS :
Existing law
1. Requires the California Conference of Local Health
Officers to establish sterilization, sanitation, and
safety standards for persons engaged in the business of
tattooing, body piercing, or permanent cosmetics.
2. Requires 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 after they are adopted
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
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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
sterilization, sanitation and safety standards.
8. Makes it a misdemeanor to tattoo, or offer to tattoo, a
person under the age of 18 years, and an infraction for
any person to offer or perform body piercing upon a
person under the age of 18 years, unless the body
piercing is performed in the presence of, or as directed
by, a notarized writing by the person's parent or
guardian or unless the person is an emancipated minor.
This bill:
1. Repeals current provisions governing the development of
standards for the body art industry.
2. Establishes the Safe Body Art Act to provide minimum
statewide standards for the regulation of tattooing,
body piercing, and permanent cosmetic application, and
defines each practice, as specified. Ear piercing
conducted using a mechanical device is excluded from the
body piercing definition.
3. Establishes restrictions on the performance of body art.
Requires parental or guardian presence for body
piercing, and allows a body art facility to refuse to
perform body piercing, regardless of parental or
guardian consent.
4. Prohibits minors from being offered or receiving a
tattoo, permanent cosmetics application, genital
piercing or branding, regardless of parental consent.
5. Allows for the application of permanent cosmetics to the
nipples of a minor when it is directed by a physician
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and with the consent of a parent or guardian.
6. Requires a client of a body art facility to read,
complete and sign an informed consent form and
questionnaire that includes medical history related to
the body art procedure, including, but not limited to,
the possibility that the client may be pregnant, have a
history of herpes infection at the proposed procedure
site, diabetes, allergic reactions to latex, hemophilia,
cardiac valve disease, have a history of medication use
and current medications. This bill requires this
information to be treated in a manner that complies with
all applicable state and federal laws, and requires any
confidential medical information to be shredded after
two years.
7. Establishes practitioner registration and health safety
training procedures, requires the registration of
practitioners with the local enforcement agency, and
allows the local enforcement agency to set the fee at an
amount sufficient to cover the actual costs of
administering the program.
8. Requires an owner of a body art facility to provide, and
a practitioner to have, training in the reduction of
bloodborne pathogen exposure and procedures to follow
should such an exposure occur, and establishes
procedures for cleaning, sterilizing, safety and
hygiene, and additional procedures and requirements, as
specified.
9. Specifies what types of inks, dyes and pigments shall be
used and the procedure in which they are applied.
10.Establishes procedures for the use of needles, needle
bars, grommets and razors, and the proper disposal of
each.
11.Requires permanent and temporary body art facilities to
obtain a health permit.
12.Requires facilities at which body art is practiced to be
safe, sanitary and be registered with the local
enforcement agency.
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13.Establishes requirements that must be met to qualify for
a body art facility permit.
14.Allows the local enforcement agency to set the fee at an
amount sufficient to cover the actual costs of
administering the program.
15.Establishes procedures, techniques and training required
to ensure safe body art practices, including an
Infection Prevention and Control Plan, body art facility
procedure area requirements and practices,
decontamination and sanitation area requirements and
practices, sterilization procedures and practices, and
other requirements as specified.
16.Establishes enforcement and non-compliance procedures,
including enforcement, inspections, citations,
suspensions and revocations of, practitioner and
business permits, as specified, and establishes
penalties for violations.
17.Establishes the local enforcement agency as the local
health agency of the city, county, city, or city and
county. In jurisdictions where the local health agency
and the environmental health agency are separate
departments, the jurisdiction is required to specify
which entity will be the local enforcement agency.
18.Allows a city, county, or city and county to adopt
regulations and ordinances that do not conflict with, or
are more stringent than, the Safe Body Art Act.
19.Establishes uniform statewide requirements for the
performance of ear piercing conducted with a mechanical
device. These requirements include what type of device
shall be used for ear piercing, notification of the
local enforcement agency, training for a person that
conducts ear piercing in the prevention of the
transmission of bloodborne pathogens and the prevention
of communicable diseases, piercing procedures, sanitary
and hygiene procedures, and additional training for a
person that will be piecing the cartilage of the upper
ear.
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20.Requires that a person must be at least 18 years of age
to conduct ear piercing with any mechanical stud and
clasp device.
21.Allows a local enforcement agency to charge a one-time
fee in an amount between $25 and $45 for each facility
operating in its jurisdiction, requires the fee amount
to not exceed the amount reasonably necessary to cover
the actual administrative and enforcement costs, and
allows, after December 31, 2014, a county to charge a
different fee, set by local ordinance, provided that the
increased fee is necessary to cover the actual costs of
administering and enforcing the program.
22.Allows DPH to promulgate regulations regarding several
areas of body art practices, which include the
Bloodborne Pathogens Exposure Control Training, the
Infection Prevention and Control Plan, body art hygiene
and sanitation procedures, ear piercing procedures,
products used in permanent cosmetics/tattooing, and
facility requirements. If DPH chooses to promulgate
these regulations, they preempt the statutes in this
bill upon adoption.
Background
In 1996, the Business Changes Report identified body art as
the fifth fastest growing business in the United States.
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 blood-borne 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 therefore are not regulated by the Food and
Drug Administration. Long-term effects of these inks are
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unknown. Specific risks of tattoos include bloodborne
diseases, skin disorders, skin infections, allergic
reactions, and complications during diagnostic imagining
such as an MRI. Piercing also carries risks, including
infection, allergies, nerve damage, and excessive bleeding.
Current requirements . AB 186 (Brown), Chapter 742,
Statutes of 1997, establishes a statutory scheme to
regulate body art practitioners, and requires the
California Conference of Local Health Officers (CCLHO) to
establish safety standards and charge a fee as a regulator,
and requires registrants to comply with the standards. DPH
and CCLHO have differed in their interpretation of
requirements of the original law. This bill ensures that
health and safety standards are adopted and met statewide.
The CCLHO is an organization of all legally appointed
health officers in the state, that was created by the
Legislature in 1995 specifically to consult with, advise,
and make recommendations to, state departments, boards,
commissions and officials of federal, state, and local
government, the Legislature, and any other organization or
association on health matters. Pursuant to AB 186, CCLHO
is directed to establish sanitation and safety guidelines
and DPH is required to review and adopt them as standards.
According to the CCLHO, it has been working with an
affiliate organization, the California Conference of
Directors of Environmental Health, for over 10 years to
draft these guidelines and urge DPH to adopt them as
standards. CCLHO states that it has been concerned that
the draft guidelines would be unenforceable and considered
"underground" regulations unless formally adopted by DPH.
However, in January 2008, DPH issued a memo concluding that
regulations are not necessary, as current law does not
explicitly require DPH to adopt these standards. DPH
contends in the memo that, while current law makes
reference to the adoption of these standards by DPH, these
references do not reflect intent by the Legislature for DPH
to adopt regulations. Rather, DPH maintains in the memo
that it was the intent of the Legislature that, following
DPH's review and consultation of the standards established
by the CCLHO, DPH would distribute the standards to each
county health department.
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FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee analysis:
Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12
2012-13 Fund
Local Enforcement unknown,
likely in the millions of Local*
dollars
Agency start-up annually; fully supported by local fees
Ongoing admin. commencing July 1, 2011
and enforcement
* LEAs would have the authority to impose fees for the
administrative and enforcement costs of this program.
Although this bill enacts a state-mandated local program,
it does not meet the criteria for state reimbursement.
SUPPORT : (Verified 8/20/10)
California Association of Environmental Health
Administrators (co-source)
Health Officers Association of California (co-source)
Alliance of Professional Tattooists (co-source)
Association of Professional Piercers (co-source)
Alameda County Environmental Health Department
American Academy of Pediatrics California District
American Nurses Association California
American Red Cross, California
Asian Week Foundation
Blood Centers of California
Body Manipulations
Calaveras County Environmental Health Department
Calaveras County Public Health Department
California Alliance for the Promotion of Safe Body Art
California Medical Association
California Sharps Coalition
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California State PTA
City of Palm Desert
City of Vernon Health and Environmental Control Department
County Health Executives Association of California
County of Butte Department of Public Health
County of Glenn Environmental Health
County of Humboldt Department of Health and Human Services
County of Lake Health Services Department
County of Marin Environmental Health Services
County of Nevada Public and Environmental Health
Departments
County of San Bernardino, Board of Supervisors
County of San Mateo, Board of Supervisors
County of Sonoma, Department of Health Services
County of Yolo, Health Department
Madera County Public and Environmental Health Departments
Mariposa County Health Department
Napa County, Department of Environmental Management
San Francisco, Department of Public Health
Studex Corporation
ARGUMENTS IN SUPPORT : The sponsors of this bill, the
California Association of Environmental Health
Administrators, the Health Officers Association of
California, and the Association of Professional Piercers
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 bloodborne disease
transmission and the licensure and regular inspection of
body art facilities are critical issues in the deferment of
over 100,000 adults with body art or body piercing. The
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Blood Centers of California further states that this
deferral of otherwise healthy adults represents the loss of
a huge donor source in all volunteer donor blood supply for
the state. The Blood Centers of California contends that
the standards and regulation of this bill provides will
result in an increase in the potential blood donor source
in California.
The Studex Corporation, responding only to the ear piercing
section of this bill, states that this bill sets clear and
consistent statewide standards for modern ear piercing,
important for the protection of customers throughout the
state. Studex adds that the bill provides much needed
certainty, clarity and statewide uniformity to the
regulatory oversight of this business. Studex contends
that this bill provides an important step in making sure
that regulatory approach and authorized activities do not
change from location to location and the rules based in
medical fact are not arbitrary.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Bradford, Brownley, Buchanan, Caballero, Charles
Calderon, Chesbro, Cook, Coto, De La Torre, Emmerson,
Eng, Evans, Feuer, Fletcher, Fong, Fuentes, Fuller,
Furutani, Gaines, Galgiani, Garrick, Gilmore, Hagman,
Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,
Jeffries, Jones, Knight, Lieu, Logue, Bonnie Lowenthal,
Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello,
Nielsen, John A. Perez, Portantino, Ruskin, Saldana,
Silva, Skinner, Smyth, Solorio, Audra Strickland,
Swanson, Torres, Torrico, Tran, Villines, Yamada
NO VOTE RECORDED: Carter, Conway, Davis, De Leon, DeVore,
Hall, V. Manuel Perez, Salas, Torlakson, Bass
CTW:do 8/23/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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