BILL ANALYSIS �
SB 1000
Page 1
Date of Hearing: June 17, 2014
ASSEMBLY COMMITTEE ON HEALTH
Richard Pan, Chair
SB 1000 (Monning) - As Amended: May 27, 2014
SENATE VOTE : 21-13
SUBJECT : Public health: sugar-sweetened beverages: safety
warnings.
SUMMARY : Establishes the Sugar-Sweetened Beverages Safety
Warning Act (Act), to be administered by the Department of
Public Health (DPH) and requires a safety warning on sugar
sweetened beverages (SSBs), as specified. Requires the safety
warning to be printed on, or affixed to, a beverage container,
vending machine, or self-service dispenser. Requires the label
to be posted in a place that is easily visible at the
point-of-purchase of an establishment where a beverage
dispensing machine is not self-serve. Specifically, this bill :
1)Establishes the Sugar-Sweetened Beverages Safety Warning Act
(Act) whereby a person, as defined, is prohibited from
distributing, selling, or offering for sale in California,
SSBs in a sealed beverage container; in a multipack of sealed
beverage containers; in concentrate form; and, on the premises
where a vending machine or beverage dispensing machine is
located and where SSBs are sold in unsealed beverage
containers unless the container bears a safety warning, as
specified, or the safety warning is posted on the premises, as
specified, and otherwise meets all the requirements of this
bill.
2)Defines "sugar-sweetened beverage" as any sweetened
non-alcoholic beverage, carbonated or non-carbonated, sold for
human consumption that has added caloric sweeteners and
contains 75 calories or more per 12 fluid ounces. Exempts
from the definition of an SSB:
a) Any beverage containing 100% natural fruit juice or
natural vegetable juice with no added caloric sweeteners;
b) Any liquid product commonly referred to as a dietary
aid;
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c) Any product for consumption by infants and that is
commonly referred to as infant formula; or,
d) Any beverage whose principal ingredient by weight is
liquid milk, milk concentrate, or dehydrated milk
(including, for the purposes of this bill, milk derived
from plant sources.)
3)Defines "caloric sweetener" as any substance containing
calories, suitable for human consumption, that is perceived as
sweet and includes sucrose, fructose, glucose, and other
sugars and fruit juice concentrates. Defines "caloric" as a
substance that adds calories to the diet of a person who
consumes that substance. Defines "non-alcoholic beverage" as
any beverage that contains less than one-half of one percent
alcohol per volume.
4)Requires the safety warning to read "STATE OF CALIFORIA SAFETY
WARNING: Drinking beverages with added sugar(s) contributes to
obesity, diabetes, and tooth decay" on the front of SSB sealed
beverage containers, separate and apart from all other
information, on a contrasting background, and entirely in bold
type. Requires the safety warning to be affixed to an SSB
beverage container in a manner that it cannot be removed
without thorough application of water or other solvents if the
warning is not printed directly on a sealed container.
Requires the warning to be placed on a vending machine and on
a self-serve beverage dispensing machine. Requires the safety
warning to be posted at the point-of-purchase if a beverage
dispensing machine is not self-serve.
5)Specifies that any violation of this bill constitutes a
violation, which beginning July 1, 2015, is punishable by a
civil penalty of not less than $50 but no greater than $500.
Specifies that a person is not to be found in violation of the
Act more than once during any one inspection visit.
6)Creates in the State Treasury the Sugar-Sweetened Beverages
Safety Warning Fund consisting of moneys collected for the
violation of the Act, which is to be appropriated by the
Legislature for allocation to local enforcement agencies for
the purpose of enforcing the Act.
7)Allows the DPH to adopt regulations to develop new language
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for the safety warning, if determined necessary by an
investigation, in consultation with the state health officer.
8)Specifies that the provisions of the Act are severable and
that any provision or its application that is held invalid
cannot affect other provisions or applications that can be
given effect without the invalid provisions or applications.
9)Makes several findings and declarations to support its
purpose.
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 the Sherman Food, Drug, and Cosmetic Law (Sherman
Act), which is administered by DPH, to regulate the contents,
packaging, labeling, and advertising of food, drugs, and
cosmetics in California.
3)Allows DPH, upon the request of a health officer, to authorize
the local health department of a city, county, city and
county, or local health district to enforce the provisions of
the Sherman Act and its regulations that pertain to retail
food establishments, as defined, if DPH determines that the
local health department has sufficient personnel with adequate
training to do so, and requires that the enforcement be
limited to the area under the jurisdiction of the local health
department.
FISCAL EFFECT : According to the Senate Appropriations
Committee, a prior version of this bill would have had one-time
costs likely between $150,000 and $300,000 to develop and adopt
regulations to implement the bill and ongoing costs of about
$400,000 per year for DPH to enforce labelling and public notice
requirements.
This bill no longer requires DPH to adopt regulations, although
regulations may still be necessary to implement the bill and
ongoing enforcement costs will remain.
COMMENTS :
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1)PURPOSE OF THIS BILL . According to the author, California is
in the midst of an obesity and diabetes epidemic that is
wreaking havoc on the public's health and sugary drinks are a
major contributor to the problem. The author states this bill
would provide information to consumers to make informed
choices by requiring warning labels, similar to those on
tobacco and alcohol, that explain the proven health risks
associated with drinking these beverages. Overwhelming
research has unequivocally shown that sugary drinks are major
contributors to obesity, diabetes, and tooth decay, which cost
California billions of dollars in health care and lost
productivity annually. Finally, the author states sugary
drinks are the biggest contributor of added calories in the
American diet and are unique in not providing any nutritional
value.
2)BACKGROUND . SSBs are drinks sweetened with sugar,
high-fructose corn syrup, or other caloric sweeteners. Common
SSBs include soda, sport drinks, energy drinks, fruit drinks,
and vitamin water drinks. According to the U.S. Department of
Agriculture (USDA), in 2009, Americans consumed 13.8 billion
gallons of SSBs, which equates to nearly 45 gallons per capita
annually of SSBs. According to the UCLA Center for Health
Policy Research, in California, 62% of adolescents ages 12-17
and 41% of children ages 2-11 drink at least one SSB every
day. In addition, 24% of adults drink at least one SSB on an
average per day.
3)OBESITY, DIABETES, AND CHRONIC ILLNESS . According to the
federal Centers for Disease Control and Prevention (CDC), more
than one-third of U.S. adults (35.7%) are obese and
approximately 12.5 million children and adolescents (17%) ages
2-19 years are now obese. Obesity-related conditions include
heart disease, stroke, type-2-diabetes and certain types of
cancer, all among the leading causes of death for Americans.
Many obese children are now diagnosed with health problems
previously considered to be "adult" illnesses, such as type 2
diabetes and high blood pressure. Obesity can affect a
person's joints, breathing, sleep, mood and energy levels. It
can also cause complications for other unrelated health
conditions that may require longer hospital stays, longer
recovery times, and increase risk to patients experiencing
co-morbidities. DPH issued a study, "The Burden of Chronic
Disease and Injury", in 2013 that highlights some of the
leading causes of death, such as heart disease, cancer,
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stroke, and respiratory disease, all of which have a strong
connection to obesity. Diabetes is another serious chronic
disease stemming from obesity that adversely affects quality
of life and results in serious medical costs. 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.
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 entr�es 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
contributor of calories and added sugars to the U.S. diet.
The Dietary Guidelines for Americans, published every 5 years
jointly by the U.S. Department of Health and Human Services
and the USDA, admonished individuals to reduce consumption of
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SSBs. In March 2014, the World Health Organization published
draft guidelines reducing the recommended sugar intake in
adults to 5% of their daily calories. For the average adult
that is equivalent to 100 calories, which is less than one
serving size of most SSBs.
6)MILK AND JUICE EXEMPTION. Milk and 100% fruit juice are
exempted from labelling under this bill, despite the fact that
flavored milk and some 100% juice have as much - or more -
sugar content as SSBs. While milk is high in calories
compared to other sugary beverages, it is also a valuable
source of calcium, vitamins, and other nutrients. Research
shows that sugar consumed with fat and protein (as in milk) is
absorbed more slowly by the body and results in more satiety
than sugar in beverages without additional nutrients. Given
the health benefits of dairy, the Dietary Guidelines for
Americans of 2010 suggests that the public increase their
intake of low-fat and fat-free milk and milk products.
Public health research is split on the risks associated with
fruit juice; some studies find juice to be a good source of
fiber, vitamins, and nutrients and can promote consumption of
recommended daily amounts of fruits and vegetables. Other
research suggests that increased sugar intake from drinking
juice correlates with prevalence of diabetes and obesity
similarly to SSBs. Most large research studies on the subject
have focused specifically on SSBs and not 100% juice, however.
As part of reducing overall added sugar intake, the CDC does
recommend reducing consumption of juice. The American Academy
of Pediatrics and other organizations acknowledge that the
vitamin C and flavonoids in juice may have beneficial
long-term health effects, but recommends limiting juice intake
to six or 12 ounces per day, depending on the age of the
child.
7)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
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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
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.
8)NUTRITION FACTS LABEL UPDATE . In February 2014, the US Food
and Drug Administration (FDA) announced an update to the
Nutrition Facts label on food packages to reflect new public
health and scientific information, including evidence on
nutrition, obesity, and chronic diseases. According to the
FDA Website, the update will reflect amounts of food people
are actually eating and drinking now as opposed to 20 years
ago when the Nutrition Facts label was first introduced. The
FDA further states that serving sizes must be based on amounts
of food and drink that people customarily consume, not on what
people should be eating.
The FDA states that the changes reflect new dietary
recommendations, consensus reports, and national survey data
and also reflect input obtained through four advance notices
of proposed rulemaking and numerous citizens' petitions.
According to the FDA, Americans on average eat 16% of their
total calories from added sugars, the major sources being
soda, energy and sports drinks, grain-based desserts,
sugar-sweetened fruit drinks, dairy-based desserts, and candy.
The proposed requirement to declare added sugars in addition
to the total sugar requirement on the Nutrition Label was
decided after taking into account new data and information,
including U.S. consensus reports and recommendations, a
citizen's petition, and public comments.
The 90-day public comment period has been extended by the FDA
to August 1, 2014. Any final rule resulting from the proposal
will become effective 60 days after the final rule's
publication in the Federal Register with a compliance date two
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years after the effective date.
9)SUPPORT . The sponsors of this bill argue that overweight,
obesity, and physical inactivity cost California's economy an
estimated $52 billion a year in unforeseen medical expenses
and lost productivity. They further state that research shows
that over the past 30 years the average American's daily
caloric intake has increased by nearly 300 calories, and 43%
of those additional calories come from additional soda
consumption.
The California Academy of Preventive Medicine states that
warning labels on tobacco products have proven effective in
reducing smoking and saved lives in California, and that a
similar approach should have some effect on over-consumption
of sugary drinks. The California Dental Association writes
that SSBs consumption creates a high risk of acid
demineralization of dental enamel and makes consumption of
these beverages one of the most significant contributors to
dental decay in children. They state that dental decay is the
most common chronic disease in California children today and
the number one reason children miss school.
The California Food Policy Advocates states that a recent
focus group of CalFresh participants in the Central Valley
revealed that while many were generally aware that SSBs are
unhealthy, several participants were unclear how SSBs are
connected to the rising obesity rates even though there is
overwhelming science linking the obesity epidemic to the
consumption of soda and other sugary drinks.
10)OPPOSITION . Several groups in opposition write that
education, rather than regulation should be the goal in
providing consumers with information about sweetened
beverages. They point out that foods with high levels of fat
can also contribute to obesity, just as any food consumed in
excess can have negative health effects.
The Valley Industry & Commerce Association and others write
the requirements of the bill are arbitrary and confusing to
consumers and point out that high-calorie milk-based products
that are also high in added sugar, like lattes, mochas, and
chai tea drinks are exempt. Californians for Food and
Beverage Choices writes that this bill is premature and
duplicitous, as the FDA is currently undergoing review of
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disclosing added sugar on all nutrition labels.
The Los Angeles Business Federation writes this bill would
financially burden businesses ranging from vending machine
operators to family-owned eateries to large, corporate-owned
grocery stores and restaurants. The California Teamsters
oppose due to possible negative effects on employment in the
food processing and transportation industries. The California
League of Food Processors writes that this bill would create
expensive and unnecessary California-only labeling
requirements that would put food processors in this state at a
competitive disadvantage relative to those in other states and
would ultimately raise food prices for consumers.
11)DOUBLE REFERRAL. This bill is double referred; upon passage
in this Committee, this bill will be referred to the Assembly
Business, Professions, and Consumer Protection Committee.
12)RELATED LEGISLATION . SB 622 (Monning) of 2013 would have
enacted the Sweetened Beverage Tax Law, which imposed a
one-cent per fluid ounce tax on any beverage that adds caloric
sweeteners, such as sodas, energy drinks, sweet teas, and
sports drinks. SB 622 would have required funds generated by
the Sweetened Beverage Tax to be directed to the newly created
Children's Health Promotion Fund and allocated to statewide
childhood obesity prevention activities and programs. SB 622
was held under submission in the Senate Appropriations
Committee.
13)PREVIOUS LEGISLATION . AB 669 (Monning) of 2011 was SB 622's
predecessor. AB 669 was held in the Assembly Revenue and
Taxation Committee.
AB 2100 (Coto) of 2010 would have imposed a one cent tax per
teaspoon of added sweetener in a bottled sweetened beverage or
in a sweetened concentrate. AB 2100 was held in the Assembly
Revenue and Taxation Committee.
SB 1210 (Florez) of 2010 was a measure similar to SB 622. SB
1210 was placed on the former Senate Revenue and Taxation
Committee's suspense file.
SB 1420 (Padilla) of 2008 required certain chain restaurants
and food facilities to disclose nutritional information on the
menu. Among other things, defined "point of sale" as the
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location where a customer makes an order. The provisions of
this bill were later repealed (SB 20 of 2011) to conform
California statute to Federal menu labelling requirements.
SB 965 (Escutia), Chapter 237, Statues of 2005, modified the
list of beverages that may be sold to pupils at an elementary,
middle or junior high school, in effect banning the sale of
sodas in schools.
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 and $0.21
per gallon of bottled soft drinks, and $0.21 per gallon of
soft drink that may be produced from powder, that is sold in
this state. The soda tax provisions were removed from the
April 29, 2002, version of the bill.
AB 105 (Moore) of 1983 would have imposed an excise tax on the
distribution of non-alcoholic 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 non-alcoholic carbonated
beverage syrup at the rate of $0.50 per gallon of liquid
syrup. This bill died in the Assembly Revenue and Taxation
Committee.
14)POLICY COMMENTS :
a) Plant-based milks definition? Plant-based sources of
milk are included in the dairy category of the USDA Dietary
Guidelines, but are not defined in state or federal
statute. Since some plant-based milks list water as the
principal ingredient, this bill could create confusion
whether such products would require the SSB warning or not.
The author may wish to clarify the definition of
plant-based milk. This could also be addressed by DPH
administratively through adoption of regulations.
b) Flavored Milk exemption: Flavor-added milks (e.g.
chocolate milk or vanilla soymilk) often contain a
significant amount of added sugar, making the caloric
intake equivalent to or greater than other SSBs. While
there are health benefits in drinking milk that balance the
excess caloric intake, the author may wish to consider
whether exempting flavored milks with added sugar is in
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line with the public health goals of this bill.
15)SUGGESTED AMENDMENT :
a) This bill specifies placing the warning label at the
point-of-purchase. It is unclear where that would be in
some restaurants, such as when the customer pays at the
table, rather than a cash register. The author may wish to
amend the bill to clarify:
111224.20 (a)(3) At the point where any consumer would
order or request a sugar-sweetened beverage in an
unsealed beverage container, when the unsealed beverage
container is filled by an employee of a food
establishment rather than the consumer.
REGISTERED SUPPORT / OPPOSITION :
Support
California Black Health Network (cosponsor)
California Center for Public Health Advocacy (cosponsor)
California Medical Association (cosponsor)
Latino Coalition for a Healthy California (cosponsor)
A World Fit for Kids
ACCESS Women's Health Justice
ACT for Women and Girls
Alameda County Board of Supervisors
Alameda County Public Health Commission
Alameda County Public Health Department
AltaMed Health Services
American Academy of Pediatrics - California
American Association of Clinical Endocrinologists
American Cancer Society - Cancer Action Network
American College of Cardiology - California Chapter
American Federation of State, County and Municipal Employees,
AFL-CIO
American Heart Association
Asian Americans Advancing Justice - Los Angeles
Asian and Pacific Islander American Health Forum
Asian Pacific Islander Obesity Prevention Alliance
Berkeley Media Studies Group
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Bike San Gabriel Valley
Black Women for Wellness
Blue Shield of California
Breathe California
California Academy of Family Physicians
California Academy of Physician Assistants
California Academy of Preventive Medicine
California Association for Health, Physical Education,
Recreation and Dance
California Association of Environmental Health Administrators
California Children and Families Commission (First 5)
California Children's Hospitals Association
California Chiropractic Association
California Conference of Local Health Department Nutritionists
California Convergence
California Coverage and Health Initiatives
California Dental Association
California Dietetic Association
California Food Policy Advocates
California Immigrant Policy Center
California Latinas for Reproductive Justice
California League of Food Processors
California Optometric Association
California Pan-Ethnic Health Network
California Park and Recreation Society
California Partnership
California Primary Care Association
California Public Health Association - North
California Rural Legal Assistance Foundation
California School-Based Health Alliance
California State Alliance of YMCAs
California State PTA
California WIC Association
Cal-Islanders Humanitarian Association
Center for Collaborative Solutions
Center for Ecoliteracy
Center for Science in the Public Interest
Central California Alliance for Health
Central California Regional Obesity Prevention Program
Central Valley Partnership for Citizenship
Centro Binacional para el Desarrollo Ind�gena Oaxaque�o
ChangeLab Solutions
Children's Hospital of Oakland
Chinese Progressive Association
City of Berkeley
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City of Carson
City of San Francisco
City of Santa Ana
Clinica Mrs. Oscar A. Romero
Coalition for Humane Immigrant Rights of Los Angeles
Community Health Improvement Partners
Congress of California Seniors
Consumer Federation of California
Contra Costa County Board of Supervisors
Contra Costa County Child Care Council
County Health Executives Association of California
County of Santa Clara
Courage Campaign
Dignity Health
Dolores Huerta Foundation
Earth Mama Healing
Ecology Center
El Quinto Sol de America
Fame Corporations
Fathers and Families of San Joaquin
First 5 Association of California
First 5 Commission of Alameda County
First 5 Commission of Los Angeles County
First 5 Commission of Monterey County
First 5 Commission of Santa Clara County
Fresno Center for New Americans
Fresno Interdenominational Refugee Ministries
Greenlining Institute
Guam Communications Network
Having Our Say Coalition
Health Education Council
Health Improvement Partnership of Santa Cruz County
Health Officers Association of California
Healthy & Active Before Five
Hermandad Mexicana
Korean Community Center of the East Bay
Korean Resource Center
Libreria del Pueblo, Inc.
Los Angeles Trust for Children's Health
Lucile Packard Children's Hospital Stanford
Madera Coalition
Mexican American Political Association
Mid-City CAN
Napa County Board of Supervisors
National Association for the Advancement of Colored People -
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California State Conference
Network of Ethnic Physician Organizations
Orfalea Foundation
Pacific Islander Cancer Survivors Network
Pacoima Beautiful
Pajaro Valley Community Health Trust
Pals for Health (Special Services Group)
Partners for Fit Youth
Philippine Medical Society of Northern California
Physicians for Social Responsibility
Prevention Institute
Public Health Institute
Roots Community Health Center/Roots Community Health Alliance
Roots of Change
San Diego County Childhood Obesity Initiative
San Diego Hunger Coalition
San Francisco County Board of Supervisors
San Francisco Unified School District
San Mateo County Board of Supervisors
Santa Clara County Board of Supervisors
Santa Cruz County Child Care Planning Council
Santa Cruz County Children's Network
Santa Cruz County Office of Education
Services, Immigrant Rights, and Education Network
Shape Up San Francisco Coalition
South Asian Network
Southern California Public Health Association
SSG/Pals for Health
Strategic Alliance for Healthy Food and Activity Environments
Street Level Health Project
The Council of Mexican Federations
United Taxi Workers of San Diego
Vision y Compromiso
Worksite Wellness L.A.
Young Invincibles
Opposition
Asian Business Association
California Asian Pacific Chamber of Commerce
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California Attractions and Parks Associations
California Automatic Vendors Council
California Chamber of Commerce
California Grocers Association
California Hotel & Lodging Association
California Independent Grocers Association
California Independent Oil Marketers Association
California League of Food Processors
California Manufactures & Technology Association
California Nevada Soft Drink Association
California Restaurant Association
California Retailers Association
California Service Station & Auto Repair Association
California Teamsters Public Affairs Council
Californians for Food and Beverage Choice
Can Manufacturers Institute
Civil Justice Association of California
Grocery Manufacturers Association
International Franchise Association
Los Angeles Area Chamber of Commerce
Los Angeles County Business Federation
National Association of Theatre Owners of California / Nevada
National Federation of Independent Business
Neighborhood Market Association
San Jose Silicon Valley Chamber of Commerce
Simi Valley Chamber of Commerce
SPI: The Plastics Industry Trade Association
The Latino Coalition
Valley Industry & Commerce Association
1 individual
Analysis Prepared by : Dharia McGrew / HEALTH / (916) 319-2097