BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:       AB 1819
          AUTHOR:        Hall
          AMENDED:       May 15, 2014
          HEARING DATE:  June 11, 2014
          CONSULTANT:    Bain

           SUBJECT  : Family day care home: smoking prohibition.
           
            SUMMARY  : Extends the existing prohibition against the tobacco  
          smoking in a private residence that is licensed as a family day  
          care home to outside the hours of operation of the home.

          Existing law:
          1.Prohibits the smoking of tobacco in a private residence that  
            is licensed as a family day care home during the hours of  
            operation as a family day care home and in those areas of the  
            family day care home where children are present. 

          2.Prohibits existing law from prohibiting a city or county from  
            enacting or enforcing an ordinance relating to smoking in a  
            family day care home if the ordinance is more stringent than  
            the above provision.

          3.Prohibits the smoking of tobacco on the premises of a licensed  
            day care center.

          4.Prohibits employers from knowingly or intentionally allowing,  
            and prohibits individuals from engaging in, the smoking of  
            tobacco products in an enclosed space at a place of  
            employment, with specified exemptions.

          This bill: repeals the exemption for family day care homes that  
          permits tobacco smoking in a private residence licensed as a  
          family care home outside of the hours of operation of the home,  
          thereby prohibiting tobacco smoking in these homes.

           FISCAL EFFECT  : According to the Assembly Appropriations  
          Committee:

          1.Unknown, likely minor, costs to the Department of Social  
            Services (DSS) for staff training and any increased complaint  
            response against licensed facilities for violation of the  
            24-hour smoking ban. 
                                                         Continued---



          AB 1819 | Page 2





          2.Any local government costs resulting from the mandate in this  
            measure would not be state-reimbursable because the mandate  
            only involves the definition of a crime or penalty for  
            conviction of a crime.

           PRIOR VOTES  :  
          Assembly Human Services:      5- 2
          Assembly Governmental Organization:14- 0 
          Assembly Appropriations:      12- 4
          Assembly Floor:               58- 13
           COMMENTS  :  
           1.Author's statement.  According to the author, while current  
            law prohibits smoking tobacco products in a family day care  
            home during the hours of operation, this policy only protects  
            children from immediate exposure to secondhand smoke (SHS).   
            It does nothing to protect children from tobacco residue that  
            lingers in the air and on surfaces hours after cigarettes have  
            been extinguished. Exposure to SHS and third hand smoke (THS)  
            leads to lifelong health issues that will require continued  
            medical attention and increased health care costs.  This bill  
            will have a direct impact on reducing childhood exposure to  
            SHS and THS and decreasing the chance of a child developing  
            health issues related to smoking.
            
          2.Tobacco use and family day care homes. Child day care  
            facilities, including family day care homes, are required to  
            be licensed by the DSS under the California Child Day Care  
            Facilities Act (the Act). A "family day care home" is a home  
            that regularly provides care, protection, and supervision for  
            14 or fewer children under age 18, in the provider's own home,  
            for periods of less than 24 hours per day, while the parents  
            or guardians are away. Family day care homes are either a  
            large family day care home (family day care for 7 to 14  
            children) or a small family day care home (8 or fewer  
            children). Under the Act, any person who willfully or  
            repeatedly violates provisions of law pertaining to child day  
            care facilities is guilty of a misdemeanor. As of September  
            2013, there were 33,481 family day care homes. AB 615 (Gotch),  
            Chapter 335, Statutes of 1993 enacted the current tobacco use  
            restriction in family day care homes. Complaints for  
            violations of the Act can be made either orally or in writing  
            to the regional Community Care Licensing Division's Child Care  
            Offices within DSS. Under existing law, when DSS receives a  
            complaint, it is required to make a preliminary review and  
            make an onsite inspection within 10 days after receiving the  




                                                            AB 1819 | Page  
          3


          

            complaint, unless it determines that the complaint is  
            willfully intended to harass a licensee or the compliant is  
            without any reasonable basis. DSS indicates it has received  
            the following number of complaints from 2008-2013 related to  
            cigarette smoking in family child care homes:

             --------------------------- 
            |Year|  Total Number of   | |
            |    |     Complaint      | |
            |    |  Allegations for   | |
            |    | Smoking in Family  | |
            |    |  Child Care Home   | |
            |    |  During Operating  | |
            |    |       Hours        | |
            |----+--------------------+-|
            |    |                    | |
            |----+--------------------+-|
            |    | Cigarette Smoking  | |
            |----+--------------------+-|
            |    |                    | |
            |----+--------------------+-|
            |2013|         30         | |
            |    |                    | |
            |----+--------------------+-|
            |    |                    | |
            |----+--------------------+-|
            |2012|         30         | |
            |    |                    | |
            |----+--------------------+-|
            |    |                    | |
            |----+--------------------+-|
            |2011|         20         | |
            |    |                    | |
            |----+--------------------+-|
            |    |                    | |
            |----+--------------------+-|
            |2010|         24         | |
            |    |                    | |
            |----+--------------------+-|
            |    |                    | |
            |----+--------------------+-|
            |2009|         24         | |
            |    |                    | |
            |----+--------------------+-|
            |    |                    | |




          AB 1819 | Page 4




            |----+--------------------+-|
            |2008|         38         | |
            |    |                    | |
            |----+--------------------+-|
            |    |                    | |
             --------------------------- 

          3.Prior legislation. AB 352 (Hall), Chapter 292, Statutes of 2013,  
            prohibits a person who is licensed or certified to provide  
            residential care in a foster family home or certified family home  
            from smoking or permitting any other person to smoke inside the  
            facility, and, when the child is present, on the outdoor grounds  
            of the facility.

          4.Support. Health care providers and anti-smoking organizations  
            write in support that broad smoke-free policies make non-smoking  
            behavior the norm, encourage smokers to quit or cut down on their  
            smoking, and thus reduce the risk of future smoking-related  
            disease. Supporters argue tobacco residue continues to linger in  
            the air and on surfaces, such as floors, countertops, upholstery,  
            carpets, clothing and other fabrics, long after a cigarette has  
            been extinguished,. Supporters argue children are the most  
            vulnerable to the effects of secondhand smoke as the developing  
            lungs of young children are severely affected by exposure to  
            secondhand smoke because children are still developing physically,  
            have higher breathing rates than adults, and have little control  
            over their indoor environments.
            
          5.Does "thirdhand smoke" present a health risk? Cigarette  
            smoking is a significant health threat for smokers and  
            non-smokers alike. According to a January 2014 study entitled  
            "Cigarette Smoke Toxins Deposited on Surfaces: Implications  
            for Human Health," THS is defined as the accumulation of SHS  
            on surfaces that ages with time that become progressively more  
            toxic, is a potential health threat to children, spouses of  
            smokers and workers in environments where smoking is, or has  
            been, allowed. The goal of the study was to investigate the  
            effects of THS on liver, lung, skin healing, and behavior,  
            using an animal model exposed to THS under conditions that  
            mimic exposure of humans. The study found THS-exposed mice  
            show alterations in multiple organ systems and excrete levels  
            of a tobacco-specific carcinogen biomarker similar to those  
            found in children exposed to SHS (and consequently to THS). In  
            the liver, THS leads to increased lipid levels and  
            non-alcoholic fatty liver disease, a precursor to cirrhosis  
            and cancer and a potential contributor to cardiovascular  




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            disease. In the lung, THS stimulates excess collagen  
            production and high levels of inflammatory cytokines,  
            suggesting propensity for fibrosis with implications for  
            inflammation-induced diseases such as chronic obstructive  
            pulmonary disease and asthma. In wounded skin, healing in  
            THS-exposed mice has many characteristics of the poor healing  
            of surgical incisions observed in human smokers. Lastly,  
            behavioral tests show that THS-exposed mice become  
            hyperactive. The latter data, combined with emerging  
            associated behavioral problems in children exposed to SHS/THS,  
            suggest that, with prolonged exposure, they may be at  
            significant risk for developing more severe neurological  
            disorders. The authors of the study state the results provide  
            a basis for studies on the toxic effects of THS in humans and  
            inform potential regulatory policies to prevent involuntary  
            exposure to THS.

           SUPPORT AND OPPOSITION  :
          Support:  Alameda County Board of Supervisors
                    American Academy of Pediatrics, California
                    American Cancer Society Cancer Action Network
                    American College of Emergency Physicians - California  
                    Chapter 
                    American Federation of State, County and Municipal  
                    Employees, AFL-CIO
                   American Lung Association
                    California Alternative Payment Program 
                   March of Dimes California Chapter
                    National Association of Social Workers, California  
               Chapter 
                   13 Individuals

          Oppose:   None received

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