BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       SB 880                                       
          S
          AUTHOR:        Yee                                          
          B
          AMENDED:       April 7, 2010                               
          HEARING DATE:  March 24, 2010                               
          8
          CONSULTANT:                                                 
          8
          Orr/                                                        
          0              
                                     SUBJECT
                                         
                       Public safety: snow sport helmets

                                     SUMMARY  

          Requires persons under 18 years of age to wear properly  
          fitted and fastened snow sport helmets while downhill  
          skiing or snowboarding. Establishes a penalty for skiers,  
          snowboarders, and/or their parent or legal guardian for  
          noncompliance. Requires snow sport helmets to meet certain  
          safety specifications, and prohibits the sale of  
          noncompliant helmets.  

                             CHANGES TO EXISTING LAW  

          Existing federal law:
          Provides that the Secretary of Agriculture is authorized to  
          issue permits for the use and occupancy of lands within the  
          National Forest System for nordic and alpine skiing  
          operations and purposes. 

          Existing state law:
          Requires a person under 18 years of age to wear a properly  
          fitted and fastened bicycle helmet while operating a  
          bicycle, or riding upon a bicycle as a passenger, upon the  
          streets or any other public bicycle path. 

          Existing law also regulates certain behavior related to  
          recreational activities and public safety, including among  
                                                         Continued---



          STAFF ANALYSIS OF SENATE BILL  880 (Yee)     Page 2


          

          other activities, skateboarding and recreational water use.

          Establishes that every person who willfully commits a  
          trespass by knowingly skiing in an area, or on a ski trail,  
          which is closed to the public and which has signs posted  
          indicating the closure is guilty of a misdemeanor. 
           
          Prohibits operators of skateboard parks from permitting any  
          person to ride a skateboard therein, unless the person is  
          wearing specified protective equipment, including a helmet.  
          Establishes that any recreational skateboard facility owned  
          or operated by a local public agency, that is not  
          supervised on a regular basis, can be deemed in compliance  
          with the protective equipment requirement by: 1) adoption  
          of a local ordinance requiring any person riding a  
          skateboard at the facility to wear protective equipment;  
          and, 2) posting signs at the facility alerting riders of  
          the requirement to wear protective equipment, and stating  
          that any person failing to do so will be subject to  
          citation.  

          This bill:
          Prohibits persons under 18 years of age from operating snow  
          skies or a snowboard, or from riding upon a seat or device  
          attached to snow skies or a snowboard, while downhill  
          skiing or snowboarding, without a properly fitted and  
          fastened snow sport helmet meeting specified standards.

          Requires snow helmets be labeled to certify that the helmet  
          conforms to applicable safety standards. 

          Prohibits the sale of helmets that do not conform to the  
          specified safety requirements.

          Establishes a fine of twenty-five ($25) dollars for any  
          violation of this section. Dismisses charges against a  
          person for violating this provision, if the person alleges  
          in court under oath that this is their first charge for  
          violating this provision. 

          Makes the parent or legal guardian of an unemancipated  
          minor jointly and severally liable with the minor for the  
          fine. 

          Exempts Nordic skiing (i.e. cross-country) from these  
          provisions. 




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          Provides that the bill does not increase or decrease  
          unspecified duties imposed under existing law. 

                                  FISCAL IMPACT  

          This bill has not been analyzed by a fiscal committee. 

                            BACKGROUND AND DISCUSSION
                                         
          The author claims that enactment of this bill will decrease  
          the number of serious injuries resulting from skiing or  
          snowboarding. The author contends that half of all skiing  
          deaths are caused by a head injury, and recent studies show  
          that when helmets are used, the incidence of traumatic  
          brain or head injury has been reduced 29 percent to 56  
          percent. Injuries that are sustained without a helmet are  
          not only dangerous, but pose significant financial  
          hardship. According to the American Medical Association,  
          first-year acute care costs for all skiers under age 17 who  
          sustain a head injury range from $1.5 million for patients  
          with mild traumatic brain injury to $82 million for those  
          with severe traumatic brain injury (TBI). Annual lifetime  
          care costs per individual, excluding first year costs,  
          range from $329,000 for mild TBI to $8.96 million for  
          severe TBI.  The author also contends that studies show  
          that kids who have been wearing helmets are more likely to  
          wear them as they get older.  



          California ski industry 
          California hosts an extensive recreational Nordic and  
          alpine skiing and snowboarding industry, with approximately  
          30 resorts drawing skiers and snowboarders from all over  
          the world every year. Nordic skiing is commonly referred to  
          as cross-country skiing, but encompasses all types of  
          skiing where the heel of the boot cannot be fixed to the  
          ski. Conversely, alpine skiing is commonly referred to as  
          downhill skiing, but encompasses skiing with fixed-heel  
          bindings.

          In November 2008, the Assembly Judiciary Committee held an  
          informational hearing on "Ski and Snowboard Health, Safety  
          and Liability Standards." The hearing concluded that the  
          ski industry has no uniform safety policies, procedures, or  




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          signage, and the safety practices that are in place tend to  
          vary from location to location. Unlike most states with  
          major ski resorts, California has no ski safety statute, no  
          proactive oversight and no established ski and snowboard  
          safety standards. 

          Most, but not all, of California's ski resorts are located  
          on federal land, which subjects them to some oversight by  
          the U.S. Forest Service.  Ski resorts located on federal  
          property are required to file annual operating or safety  
          plans with the U.S. Forest Service. Although the U.S.  
          Forest Service has contractual authority to enforce safety  
          improvements on land leased to ski resorts, with no  
          established national safety standards, the Forest Service  
          takes a "hands-off" position on safety regulation.  
          Individuals testifying at the informational hearing  
          reported great difficulty in obtaining copies of the plans  
          from the U.S. Forest Service when they filed the required  
          Freedom of Information Act (FOIA) requests.
          
          The California ski industry enjoys legal liability  
          protection through a common law doctrine of "assumed risk"  
          as well as contractual negligence waivers included on ski  
          pass purchase agreements.  As a result of these  
          protections, ski resorts have limited exposure to legal  
          liability.  There is no publicly accessible, statewide  
          repository of information on ski resort related deaths and  
          injuries. 
          
          Risk of injury from skiing
          According to the National Ski Areas Association, serious  
          injuries (paraplegics, serious head and other serious  
          injuries) occur at the rate of about 43.6 per year.  In the  
          2007/2008 season, there were 41 serious injuries.   
          Thirty-two of these serious injuries were skiers and nine  
          were snowboarders.  The rate of serious injury in 2007/2008  
          was 0.68 per million skier/snowboarder visits.  According  
          to a Centers for Disease Control and Prevention (CDC) study  
          in the journal, Wilderness and Environmental Medicine, more  
          people are hurt snowboarding than any other outdoor  
          activity, accounting for a quarter of emergency room  
          visits.  Almost 213,000 people were treated each year in  
          emergency departments for outdoor recreational injuries  
          from 2004 to 2005.  Of those injured, about 109,000 (51.5  
          percent) were young people between the ages of 10 and 24. 





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          Ski helmet usage
          The purpose of the helmet is to partially absorb the force  
          of blunt trauma and dissipate the energy so that the head  
          alone does not sustain the total force of the blow. While  
          helmets do not decrease the risk of injury, they can  
          decrease the severity. Ski helmets are graded on their  
          ability to withstand frontal blunt and sharp impact,  
          retention strength, and resistance to roll off. American  
          standards indicate that those helmets with a rating of RS  
          98 from the Snell Memorial Foundation of the American  
          National Standards Institute (ANSI) have the highest level  
          of protection in all tested areas of impact.

          Helmet utilization in the U.S. is increasing by about five  
          percent per year for the last several years. In the  
          2004/05, season the overall usage of helmets among the  
          general public (skiers and snowboarders) was estimated to  
          be 33.2 percent. It was higher among children 9 and under  
          at 66 percent; it was next highest among those over 65, at  
          46 percent. Only 19 percent of entry level skiers and  
          snowboarders used a helmet versus advanced/expert at 45  
          percent. Among males, 35.2 percent used a helmet, and 30.4  
          percent of females wore a helmet. 


          In January 1999, the U.S. Consumer Product Safety  
          Commission (CPSC) released a report on an investigational  
          study of skiing- and snowboarding-related head and neck  
          injuries, in an attempt to determine whether helmets would  
          have prevented or reduced the severity of the injuries they  
          studied. They note that head injuries account for 14  
          percent of skiing and snowboarding accidents, as well as 56  
          percent of related deaths. Falls were the leading cause of  
          head and neck injuries, when individuals either hit a  
          surface (48 percent) or hit their ski equipment (21  
          percent). About two-thirds of the falls to a surface  
          resulted in injuries to parts of the head which were  
          identified as addressable by use of a helmet. Overall, the  
          study indicated that 44 percent of head injuries, an  
          estimated 7,700 injuries annually, could be addressed by  
          helmet use. The study also showed that for children under  
          15 years of age, 53 percent of head injuries (approximately  
          2,600 of the 4,950 head injuries annually) are addressable  
          by use of a helmet.  






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          US CPSC noted that studies have shown safety helmets for  
          motorcycling and bicycling provide effective protection  
          against head and brain injuries, including severe brain  
          injuries.  They believe it is reasonable to suggest from  
          the bicycling and motorcycling experience that a skiing  
          helmet that meets a suitable standard could provide  
          effective protection against head and brain injuries in  
          many types of skiing-related incidents involving head  
          impact. Based on this information as well as their  
          investigational study, they conclude that the use of  
          helmets will reduce the risk of head injury associated with  
          skiing and snowboarding. 


          Traumatic brain injury 

          According to the CDC's National Center for Injury  
          Prevention and Control, the leading causes of traumatic  
          brain injury (TBI) are: falls (35.2%), motor vehicle -  
          traffic (17.3%); struck by/against events (16.5%); and  
          assaults (10%). Falls are the leading cause of non-fatal  
          injuries for all children ages 0 to 19. Every day,  
          approximately 8,000 children are treated in U.S. emergency  
          rooms for fall-related injuries. This adds up to almost 2.8  
          million children each year. 

          In January 2010, the Senate Committee on Health convened a  
          hearing on traumatic brain injury. The California Brain  
          Injury Association testified that 220,000 Californians  
          sustain brain injuries each year, not including  
          144,000-342,000 sports-related concussions estimated to  
          occur in the state each year. Approximately 52,250 children  
          sustain a brain injury and or are hospitalized with a brain  
          injury each year. Disease management for brain injury  
          includes emergency care, intensive care, hospital-based  
          rehabilitation, non-hospital based rehabilitation, and  
          vocational rehabilitation. The nationally annualized direct  
          costs of TBI have been estimated to range between $51.2 and  
          $60 billion in the U.S. Cost of care for a single disabled  
          person with brain injury over a lifetime can range from $1  
          to $30 million. The true extent of the economic impact to  
          the state cannot be realized because the state has no  
          epidemiology and surveillance program that thouroughly  
          tracks brain injury. 






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          Ski helmet laws in other locales

          Several other states have general ski safety laws,  
          including Alaska, Arizona, Colorado and Michigan. According  
          to a March 15 USA Today article, New York and New Jersey  
          are currently considering legislation to mandate ski  
          helmets. The most promising New York bill would require  
          skiers under 15 to wear a helmet. The New Jersey bill, if  
          passed, would require helmets for skiers and snowboarders  
          under age 14.  Lawmakers in Quebec also considered  
          requiring helmet use after actress Natasha Richardson died  
          after a fall in 2009, but so far no legislation has been  
          introduced.

          Related bills
          AB 1652 (Jones) of 2010 would require ski resorts to  
          prepare an annual safety plan and create a monthly summary  
          report stating the number of deaths and injuries at the  
          resort.  Requires a person under 18 years of age and a  
          person employed by a ski resort to wear a properly fitted  
          and fastened snow sport helmet when operating snow skis or  
          a snowboard.

          Prior legislation
          AB 990 (Jones) of  2009 would have required ski resorts to  
          prepare and file an annual safety report with Division of  
          Occupational Safety and Health (DOSH) and to report to the  
          DOSH on a quarterly basis any serious injuries or  
          fatalities involving patrons at the ski resort. Held in  
          Assembly Appropriations Committee.

          SB 284 (Cox) of 2009 would have required DOSH to utilize  
          the most current safety standards when inspecting aerial  
          passenger tramways operated at ski resorts.  The bill would  
          have also required ski resorts to file an annual safety  
          plan with the DOSH, make the safety plan available on  
          demand, report to DOSH, within 24 hours, any fatalities  
          involving patrons at the resort, and standardize safety  
          signage and equipment padding in use at the resort.  The  
          bill died in the Senate Labor and Industrial Relations  
          Committee.  

          SB 1924 (O'Connell) Chapter 475, Statutes of 2002, requires  
          that persons under 18 years of age wear a helmet while  
          operating a nonmotorized scooter or skateboard or riding  
          upon a nonmotorized scooter or skateboard as a passenger. 




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          AB 2218 (Keeley) of 2002 would have created the California  
          Ski Safety Task Force, required the Task Force to adopt  
          uniform sign standards for adoption by California ski  
          areas, and required the Task Force to make recommendations  
          regarding safety. 

          AB 2268 (Caldera) Chapter 1000, Statutes of 1993,   
          prohibits a person under 18 years of age from operating, or  
          riding upon a bicycle as a passenger, upon a street,  
          bikeway, or other public bicycle path or trail unless the  
          person is wearing a helmet meeting specified standards. The  
          bill provides for fines to be imposed for violations of  
          this prohibition and requires all the revenue derived from  
          the fines to be allocated as specified. Requires that the  
          charge against a person be dismissed if it is the first  
          charge against that person for a violation of this  
          prohibition. The bill requires any safety helmet sold or  
          offered for sale to be conspicuously labeled in accordance  
          with the specified standards and would prohibit the sale or  
          offer for sale of any bicycle safety helmet which is not of  
          a type meeting the safety standards.
          Arguments in support
          The California Psychological Association claims  
          neuropsychological research has shown that half of all  
          skiing deaths are caused by a head injury. Observations on  
          acute rehabilitation units from brain injured patients  
          demonstrates that individuals who wore helmets during their  
          accidents seemed to have less severe injuries and were  
          consequently discharged earlier, with less in the way of  
          post-discharge services. Individuals wearing helmets were  
          more likely to return to pre-accident levels of functioning  
          sooner, compared to their non-helmeted counterparts.  

          The California Chapter of the American College of Emergency  
          Physicians (CAL/ACEP) supports injury and illness  
          prevention legislation, and is a long-standing supporter of  
          California's motorcycle helmet law. During the winter  
          months, CAL/ACEP members see many young patients with  
          injuries resultant from ski and snowboard accidents, many  
          of which could have been avoided if helmets were used. The  
          California Brain Injury Association claims that because the  
          young developing brain is more sensitive to trauma, and  
          because children have weaker necks than adults, brain  
          injuries sustained by children are more damaging. They  
          believe that prevention is the only cure for brain injury. 




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          The California Chiropractic Association cites that skiing  
          and snowboarding are inherently dangerous sports, but when  
          ski safety is ignored, serious injury can result. They  
          believe this bill ensures that ski resorts are following  
          the law and taking every reasonable safety precaution. They  
          support this bill because it has the potential to prevent  
          some of the devastating musculoskeletal injuries that  
          doctors of chiropractic treat every winter. 
          
          Arguments in opposition
          The National Ski Areas Association writes in opposition to  
          the bill, and claims they would support legislation for ski  
          helmets if it places sole responsibility for wearing  
          helmets on parents and participants, and sole  
          responsibility for enforcement on law enforcement. They  
          believe parents should be responsible not only for their  
          child's helmet usage, but other aspects of their equipment  
          as well. They would like the bill to be amended to  
          specifically state that winter sport resort operators are  
          not responsible for enforcement of this section, and  
          believe that without this amendment, their resorts will  
          still be held liable for enforcement responsibilities.  The  
          California Ski Industry Association also opposes the bill  
          for similar reasons. 

                                     COMMENTS

           1.  Lack of enforcement.  As SB 880 is drafted, no entity  
          would be directly responsible for enforcing the provisions  
          of the bill, nor does the bill contain any mechanisms to  
          ensure compliance. While the bill mimics existing law  
          requiring bicyclists to wear helmets, which is enforced by  
          police and highway patrol officers who patrol roadways, law  
          enforcement is not a natural enforcement entity for this  
          bill, because the locations of the potential violations  
          (ski slopes) are not places where most law enforcement  
          entities conduct routine patrols. Two options for ensuring  
          better enforcement are: 
               1) Mimicking requirements in existing statute  
               governing unsupervised recreational skate parks.   
               Operators of skateboard parks are prohibited from  
               permitting any person to ride a skateboard therein,  
               unless the person is wearing specified protective  
               equipment, including a helmet. Local agencies, cities,  
               or counties with public recreational skateboard  




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               facilities that are not supervised on a regular basis,  
               implement this law by adopting a local ordinance  
               requiring any person riding a skateboard at the  
               facility to wear protective equipment, and by posting  
               signs at the facility alerting boarders of the  
               ordinance and that violators of the ordinance are  
               subject to a citation. 
               2) Placing enforcement responsibility on ski resort  
               operators.  Ski resort operators could be required to  
               revoke passes of noncompliant minors, or issue  
               citations to noncompliant minors or parents.  
               Conversely, they could be required to report  
               violations to local law enforcement, which could then  
               enforce the provisions. However, enforcement questions  
               would remain, such as who would enforce the ski  
               resorts' compliance? 

          Other ways to strengthen the enforcement of the bill could  
          be to create a complaint process for people to issue  
          complaints when resorts are not enforcing the law, require  
          lift ticket sellers or equipment rental providers to give  
          information to purchasers about the new law at the  
          point-of-sale, or creating an authorization or release form  
          for skiers and snowboarders to verify their awareness of  
          the law and certify their intent to comply.

          2.  Fines. The provisions in the bill dealing with fines  
          raise several issues. 1) The bill levies a fine of $25 for  
          violations of this bill, and waives the fine for first-time  
          offenders. It is not clear if this level of fine is enough  
          to affect behavior. Suggested amendments would be to  
          incorporate graduated fines of $25 for the first offense,  
          $50 for the second offense, and $100 for each subsequent  
          offense. 2) The bill imposes the same fine to sellers of  
          helmets. A suggested amendment would be to increase the  
          level of the fines for sellers of sport helmets and also  
          institute a graduated fine for multiple offenses. 3) No  
          entity is designated to receive the fines collected  
          pursuant to this bill. The author may wish to designate an  
          appropriate entity to receive the fines. 


                                   POSITIONS  

          Support:  California Psychological Association (sponsor)
                 American Board of Trial Advocates




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                 American College of Emergency Physicians, California  
          Chapter
                 American Psychological Association, Division of  
          Clinical
                           Neuropsychology
                 Association of California Insurance Companies
                 California Brain Injury Association
                 California Children's Hospital Association
                 California Chiropractic Association
                 California Emergency Nurses Association
                 California Hospital Association
                 California Medical Association
                 California Nurses Association
                 California Psychiatric Association
                 California School Nurses Organization
                 Children's Advocacy Institute
                 Los Angeles County Psychological Association
                 National Academy of Neuropsychology
                 Richmond Area Multi-Services, Inc.
                 San Gabriel Valley Psychological Association
                 San Francisco Psychological Association
                 Santa Barbara County Psychological Association
                 Santa Clara Psychological Association
                 
          Oppose:  California Ski Industry Association
                 National Ski Areas Association

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