BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair


          AB 1278 (Hill) - Health Facilities: smoking.
          
          Amended: June 20, 2012          Policy Vote: Health 6-1
          Urgency: No                     Mandate: No
          Hearing Date: July 2, 2012      Consultant: Brendan McCarthy
          
          This bill does not meet the criteria for referral to the 
          Suspense File.
          
          
          Bill Summary:  AB 1278 expands the existing prohibition on 
          smoking in general acute care hospitals, to the entire hospital 
          campus.

          Fiscal Impact: 
              Minor enforcement costs to the Department of Public Health, 
              which licenses hospitals.

              Unknown, potentially offsetting impacts on state tobacco 
              tax revenue and/or state public health coverage programs. 
              See staff comments below.

          Background:  Under current law, the Health and Safety Code 
          prohibits smoking in patient care areas of hospitals, with 
          certain exceptions. A violations of these requirements is an 
          infraction and is punishable by a fine up to $100.

          Also under current law, the Labor Code generally prohibits an 
          employer from permitting tobacco smoking in enclosed spaces at 
          places of employment, with certain exceptions.

          Proposed Law:  AB 1278 would prohibit smoking in all areas of a 
          hospital campus, beginning on March 1, 2013. This prohibition 
          would be an extension of the existing prohibition in the Health 
          and Safety Code. The bill's prohibition would not apply when the 
          treating physician determines a patient's treatment will be 
          negatively impacted by denial of tobacco or on property owned by 
          a hospital but which is not part of the main hospital campus.

          The bill requires hospitals to post notice of the prohibition 
          and to inform new employees of the prohibition. 









          AB 1278 (Hill)
          Page 1


          The bill eliminates the existing infraction penalty for 
          noncompliance with the prohibition of smoking in hospitals (or 
          on a hospital campus).

          Related Legislation: 
              SB 575 (Desaulnier) would eliminate most exceptions to the 
              existing prohibition on smoking in places of employment. 
              That bill is in the Assembly Governmental Organization 
              Committee.

              AB 217 (Carter) would restrict smoking in long-term care 
              facilities, by only allowing smoking in designated, outdoor 
              smoking areas. That bill is in the Senate Labor and 
              Industrial Relations Committee.

          Staff Comments: The state of California imposes a tax of $0.87 
          per pack of cigarettes, with the proceeds divided between the 
          General Fund and several special funds. To the extent that this 
          bill will lead to smokers who work on hospital campuses to 
          reduce their smoking or quit entirely, this bill could lead to 
          reduced tax revenue. The extent to which this will occur is 
          unknown. However, if only a few employees per hospital quit 
          smoking because of this prohibition, total revenue losses could 
          be in the tens of thousands per year (various funds).

          On the other hand, smoking is associated with significant 
          long-term health care costs. The Department of Public Health 
          indicates that the average health care cost of smoking related 
          illness, per smoker in the state, is about $1,700 per year. Any 
          reduction in smoking in the state may reduce health care costs, 
          including costs incurred by the state's health care programs 
          such as Medi-Cal.