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HomeMy WebLinkAboutMINUTES - 06172014 - C.27RECOMMENDATION(S): ADOPT a "Support" position on SB 1000 (Monning), as amended: Public Health: Sugar-Sweetened Beverages: Warnings, a bill that would prohibit a person from distributing, selling, or offering for sale a sugar-sweetened beverage in a sealed beverage container, or a multipack of sugar-sweetened beverages, in this state unless the beverage container or multipack bears a specified safety warning, as recommended by the Legislation Committee. FISCAL IMPACT: According to the Senate Appropriations Committee: * One-time costs likely between $150,000 and $300,000 to develop and adopt regulations to implement the bill (General Fund). Department of Public Health (DPH) indicates that the language of the bill is specific enough that it will not necessarily require implementing regulations to clarify terms or set forth compliance requirements. In addition, the existing regulations that allow the DPH to delegate authority for enforcement of portions of the Sherman Act to local agencies do not include the new sections added to the Health and Safety Code by this bill. * Ongoing costs of about $400,000 per year for DPH to enforce labeling and public notice requirements (General Fund). APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 06/17/2014 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor Contact: L. DeLaney, 925-335-1097 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: June 17, 2014 David Twa, County Administrator and Clerk of the Board of Supervisors By: Stephanie L. Mello, Deputy cc: C. 27 To:Board of Supervisors From:LEGISLATION COMMITTEE Date:June 17, 2014 Contra Costa County Subject:SB 1000: Public Health: Sugar-Sweetened Beverages: Warnings (Monning), as amended FISCAL IMPACT: (CONT'D) Under current law, DPH enforces requirements of the Sherman Food, Drug, and Cosmetic Law at food processing and distribution sites. DPH indicates it could enforce the provisions of this bill at those sites using existing resources. However, the bill also requires enforcement at a very large number of retail food sale sites. Under current practice, the DPH does not inspect or enforce food safety laws at retail sites. Because local environmental health officers do not generally have the legal infrastructure to impose civil penalties, DPH will likely need to respond to complaints, conduct spot inspections, and assess civil penalties for violations of the bill's requirements. To the extent that local environmental health officers opt to enforce the bill's provisions at retail food facilities, the costs for DPH to conduct spot checks at such facilities will be reduced. * Unknown impacts on state agencies that own or operate cafeterias, vending machines, or other retail sales locations (various funds). To the extent that state agencies will be subject to the regulatory requirements of the bill, there could be administrative costs to comply. For example, the requirement to maintain records of sales of covered beverages could impose additional administrative costs. It is not clear, however, the extent to which state agencies will be regulated under the bill. Typically, state agencies that host food facilities contract out for those services. In those cases, the costs of compliance should generally be a responsibility of the vendor. If the costs of compliance are large, a vendor could seek to pass those costs along to customers and/or to the contracting state agency. The bill also requires that owner of premises where covered beverages are sold or dispensed are obligated to comply with the bill's requirements. Even if state agencies contract out for services that sell covered benefits, there could be some administrative cost to ensure that vendors are complying with the law. * Unknown potential savings to state health programs (various funds). Obesity-related health conditions, such as diabetes, heart disease, and other conditions are a major driver of health care costs in the United States. There is a clear association between the increased consumption of high-calorie, sugar-sweetened beverages and the rise of obesity in the United States over the last several decades. If this bill is successful in reducing the consumption of sugar-sweetened beverages (and consumers do not switch to other high-sugar beverages not covered by the bill), there will likely be some long-run reduction in overweight and obesity rates. The extent of this impact is unknown. To the extent that the bill is able to reduce overweight and obesity rates in the state, there are likely to be corresponding reductions in spending by state health programs, such as Medi-Cal and CalPERS health care programs. BACKGROUND: At its June 5, 2014 meeting, the Legislation Committee considered the recommendation from the Director of Health Services to recommend a position of "Support" to the Board of Supervisors on SB 1000. Current Status : 05/29/2014: In SENATE. Read third time. Passed SENATE. *****To ASSEMBLY. SUBJECT : Public health: sugar-sweetened beverages: safety warnings DIGEST : This bill establishes the Sugar-Sweetened Beverages Safety Warning Act (SSBSWA), to be administered by the Department of Public Health (DPH), and requires a safety warning on all sealed sugar-sweetened beverage (SSB) containers; multipacks of sealed containers; packages of concentrates, as defined; vending machines; and self-serve beverage dispensing machines. Requires the safety warning to be affixed to beverage containers, as specified, if the safety warning is not printed directly on the container. 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. ANALYSIS: 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. This bill: 1. Establishes the SSBSWA whereby a person, as defined, is prohibited from distributing, selling, or offering for sale in the state SSBs in a sealed beverage container; in a multipack of sealed beverage containers; in concentrate form, as defined; on the premises where a vending machine or beverage dispensing machine, as defined, 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, as specified. 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. Specifies that SSBs do not include any beverage containing 100% natural fruit juice or natural vegetable juice with no added caloric sweeteners; any liquid product commonly referred to as a dietary aid; any product for consumption by infants and that is commonly referred to as infant formula; or any beverage whose principal ingredient by weight is natural liquid milk. 3. Defines "non-alcoholic beverage" as any beverage that contains less than one-half of one percent alcohol per volume. Defines "caloric sweetener" as any substance containing calories, suitable for human consumption, that humans perceive as sweet and includes, without limitation, 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. 4. Requires the safety warning to read "STATE OF CALIFORNIA 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. Beginning July 1, 2015, any violation of the SSBSWA 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 SSBSWA more than once during any one inspection visit. 6. Creates, in the State Treasurer's Office, the Sugar-Sweetened Beverages Safety Warning Fund consisting of moneys collected for the violation of the SSBSWA, which is to be appropriated by the Legislature for allocation to local enforcement agencies for the purpose of enforcing the SSBSWA. 7. Allows DPH to adopt regulations to develop new language for the safety warning, if necessary. 8. Specifies that the provisions of the SSBSWA 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. BACKGROUND According to the U.S. Department of Agriculture, in 2009, Americans consumed 13.8 billion gallons of SSBs, which equates to nearly 45 gallons per capita annually of SSBs with added caloric sweeteners. 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. Adults who drink SSBs occasionally (not every day) are 15% more likely to be overweight or obese, and adults who drink one or more SSBs per day are 27% more likely to be overweight or obese than adults who do not. According to a report produced by the Robert Wood Johnson Scholar's Program, SSBs were the single largest contributor to energy intake during the last decade, and SSB consumption has increased by almost 500% during the past 50 years. Prior Legislation SB 622 (Monning, 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. AB 669 (Monning, 2011) was SB 622's predecessor. AB 669 was held in the Assembly Revenue and Taxation Committee. AB 2100 (Coto, 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, 2010) was a measure similar to SB 622. SB 1210 was placed on the former Senate Revenue and Taxation Committee's suspense file. SB 1520 (Ortiz, 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, 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. SUPPORT: (Verified 5/28/14) California Black Health Network (co-source) California Center for Public Health Advocacy (co-source) California Medical Association (co-source) Latino Coalition for a Healthy California (co-source) A World Fit For Kids! Alameda County 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 Federation of State, County and Municipal Employees, AFL-CIO American Heart Association Asian Pacific Islander Obesity Prevention Alliance Asian & Pacific Islander American Health Forum Berkeley Media Studies Group Bike San Gabriel Valley Blue Shield of California California Academy of Family Physicians California Academy of Physician Assistants California Association for Health, Physical Education, Recreation and Dance California Association of Environmental Health Administrators California Children's Hospital Association California Chiropractic Association California Conference of Local Health Department Nutritionists California Convergence California Dental Association California Dietetic Association California Food Policy Advocates California Optometric Association California Pan-Ethnic Health Network California Park & Recreation Society 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 WIC Association Center for Collaborative Solutions Center for Ecoliteracy Center for Science in the Public Interest Central California Alliance for Health Central CA Regional Obesity Prevention Program ChangeLab Solutions Children's Hospital Oakland City of Berkeley City of Carson City of Santa Ana Community Health Improvement Partners Congress of California Seniors Consumer Federation of California Courage Campaign Day One Dignity Health Ecology Center FAME Corporations First 5 Alameda County First 5 Association of California First 5 California First 5 LA First 5 Santa Clara County Greenlining Institute Guam Communications Network Having Our Say Coalition Health Education Council Health Improvement Partnership of Santa Cruz Health Officers Association of California Healthy & Active Before 5 Libreria Del Pueblo, Inc. Los Angeles Trust for Children's Health Lucile Packard Children's Hospital Stanford Network of Ethnic Physicians Orfalea Foundation Pacific Islander Cancer Survivors Network Pacoima Beautiful Pajaro Valley Community Health Trust Partners for Fit Youth Philippine Medical Society of Northern California Public Health Institute San Diego County Childhood Obesity Initiative San Diego Hunger Coalition San Francisco County and City San Mateo County Santa Clara County Santa Cruz County Santa Cruz County Child Care Planning Council Santa Cruz County Children's Network SF Bay Area Physicians for Social Responsibility Shape Up San Francisco Coalition Southern CA Public Health Association Strategic Alliance for Healthy Food and Activity Environments Street Level Health Project Vision y Compromiso Worksite Wellness LA OPPOSITION: (Verified 5/28/14) Asian Business Association California Asian Pacific Chamber of Commerce California Automatic Vendors Council California Chamber of Commerce California Grocers Association California Hotel & Lodging Association California League of Food Processors California Independent Oil Marketers Association California Manufacturers & Technology Association California Nevada Soft Drink Association California Restaurant Association California Retailers Association California Service Station & Auto Repair Association California Teamsters Public Affairs Council Grocery Manufacturers Association International Franchise Association The Latino Coalition Los Angeles County Business Federation National Association of Theatre Owners of CA/NV Neighborhood Market Association Simi Valley Chamber of Commerce San Jose Silicon Valley Chamber of Commerce ARGUMENTS IN SUPPORT: According to the author, California is in the midst of an obesity and diabetes epidemic that is wreaking havoc on the public's health. Sugary drinks are a major contributor to the problem. This bill provides 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. The science is clear and conclusive. 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. Nearly 40% of California children are currently overweight or obese. Liquid sugar has a unique role in driving today's skyrocketing cases of preventable diabetes. Individuals who drink one or two sugary drinks per day have a 26% higher risk for developing type-2 diabetes and if current trends are not reversed, it is predicted that one in three children, and nearly half of Latino and African American children, born in the year 2000 will develop type-2 diabetes in their lifetime. Sugary drinks are the biggest contributor of added calories in the American diet and are unique in not providing any nutritional value. The sponsors and many other supporters 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 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. The Center for Science in the Public Interest argues that major soft drink companies have steadily increased the sizes of popular single-serving containers in order to encourage ever greater consumption. The Center states that soft drinks have become the most consumed food or beverage in the United States. ARGUMENTS IN OPPOSITION: The California Teamsters Public Affairs Council writes in opposition of this bill and states that almost any food that is consumed in excessive amounts can have negative health effects. The Council is concerned that this bill will have a negative effect on employment for its members and states that this bill would likely result in warning labels on everything that can be unhealthy. A coalition of opponents writes in opposition of this bill arguing that it contains inconsistencies that would be confusing to consumers, such as requiring warning labels on some products but not on others, such as- high calorie milk-based products that are also high in sugar. They also argue that it does not make sense for the state legislature to mandate additional California labeling when a new, national effort is already going forward, through the FDA's proposal to update nutrition labels for all food and beverage products. CONSEQUENCE OF NEGATIVE ACTION: Contra Costa County would not be able to provide a position on this bill. CHILDREN'S IMPACT STATEMENT: Liquid sugar is a unique driver of today's skyrocketing diabetes and obesity epidemics. Diabetes rates have almost tripled over the past three decades, just as soda consumption has doubled. Today, over 60 percent of California's adults (16.6 million in total) and nearly 40 percent of the state's children are overweight, leading to higher incidences of diabetes, heart disease, cancer and asthma. Overweight, obesity and physical inactivity cost the state's economy $52 billion a year in medical expenses and lost of productivity. Additionally, children who frequently consume sugary beverages are at a dramatically increased risk for dental cavities, which untreated can lead to pain, infection and tooth loss. SB 1000 will help unravel the state's diabetes and obesity epidemics by requiring all sugary drink bottles, cans, vending machines, dispensers, and restauranteurs to display a warning that clearly states that drinking beverages with added sugar(s) contributes to obesity, diabetes and tooth decay. ATTACHMENTS SB 1000 Bill Text SB 1000 CCLHO support letter SB 1000 Fact Sheet AMENDED IN SENATE MAY 27, 2014 AMENDED IN SENATE MARCH 27, 2014 SENATE BILL No. 1000 Introduced by Senator Monning (Coauthors: Senators DeSaulnier, Lara, Leno, Mitchell, and Steinberg) (Coauthors: Assembly Members Ammiano and Williams) February 13, 2014 An act to add Article 15 (commencing with Section 111224) to Chapter 5 of Part 5 of Division 104 of the Health and Safety Code, relating to public health. legislative counsel’s digest SB 1000, as amended, Monning. Public health: sugar-sweetened beverages: safety warnings. (1)  Existing federal law, the Federal Food, Drug, and Cosmetic Act, regulates, among other things, the quality and packaging of foods introduced or delivered for introduction into interstate commerce and generally prohibits the misbranding of food. Existing federal law, the Nutrition Labeling and Education Act of 1990, governs state and local labeling requirements, including those that characterize the relationship of any nutrient specified in the labeling of food to a disease or health-related condition. Existing state law, the Sherman Food, Drug, and Cosmetic Law, generally regulates misbranded food and provides that any food is misbranded if its labeling does not conform with the requirements for nutrient content or health claims as set forth in the Federal Food, Drug, and Cosmetic Act and the regulations adopted pursuant to that federal act. Existing law requires that a food facility, 97 as defined, make prescribed disclosures and warnings to consumers, as specified. A violation of these provisions is a crime. Existing state law, the Pupil Nutrition, Health, and Achievement Act of 2001, also requires the sale of only certain beverages to pupils at schools. The beverages that may be sold include fruit-based and vegetable-based drinks, drinking water with no added sweetener, milk, and in middle and high schools, an electrolyte replacement beverage if those beverages meet certain nutritional requirements. This bill would establish the Sugar-Sweetened Beverages Safety Warning Act, which would prohibit a person from distributing, selling, or offering for sale a sugar-sweetened beverage in a sealed beverage container, or a multipack of sugar-sweetened beverages, in this state unless the beverage container or multipack bears a specified safety warning, as prescribed. The bill also would require every person who owns, leases, or otherwise legally controls the premises where a vending machine or beverage dispensing machine is located, or where a sugar-sweetened beverage is sold in an unsealed container to place a specified safety warning in certain locations, including, on the exterior of any vending machine that includes a sugar-sweetened beverage for sale. This bill would require every person that distributes, sells, or offers for retail sale a sugar-sweetened beverage to maintain on its business premises, for a period of two years following each distribution, purchase, or sale, all records, including legible invoices and purchase orders, to determine the quantity and type of sugar-sweetened beverages distributed, purchased, or sold. (2)  Under existing law, the State Department of Public Health, upon the request of a health officer, as defined, may authorize the local health department of a city, county, city and county, or local health district to enforce the provisions of the Sherman Food, Drug, and Cosmetic Law. Existing law authorizes the State Department of Public Health to assess a civil penalty against any person in an amount not to exceed $1,000 per day, except as specified. Existing law authorizes the Attorney General or any district attorney, on behalf of the State Department of Public Health, to bring an action in a superior court to grant a temporary or permanent injunction restraining a person from violating any provision of the Sherman Food, Drug, and Cosmetic Law. This bill, commencing July 1, 2015, would provide that any violation of the provisions described in (1) above, or regulations adopted pursuant to those provisions, is punishable by a civil penalty of not less than $50, 97 — 2 —SB 1000 but no greater than $500. By imposing additional enforcement duties on local agencies, this bill would impose a state-mandated local program. This bill would also create the Sugar-Sweetened Beverages Safety Warning Fund for the receipt of all moneys collected for violations of those provisions. The bill would allocate moneys in this fund, upon appropriation by the Legislature, to the department local enforcement agencies for the purpose of enforcing those provisions. This bill would also require the State Department of Public Health to adopt regulations for the implementation of those provisions. The bill would make legislative findings and declarations relating to the consumption of sugar-sweetened beverages, obesity, and dental disease. (3)  The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions. Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes. The people of the State of California do enact as follows: line 1 SECTION 1. The Legislature finds and declares all of the line 2 following: line 3 (a)  The prevalence of obesity in the United States has increased line 4 dramatically over the past 30 years. In California, adult obesity line 5 rates have increased from 8.9 percent in 1984 to 25.0 percent in line 6 2012, and if current trends continue, the rate is expected to increase line 7 to 46.6 percent in 2030. Nearly 40 percent of California children line 8 are currently overweight or obese. Although no group has escaped line 9 the epidemic, low income and communities of color are line 10 disproportionately affected. line 11 (b)  The obesity epidemic is of particular concern because obesity line 12 increases the risk of diabetes, heart disease, arthritis, asthma, and line 13 certain types of cancer. Depending on their level of obesity, from line 14 60 percent to over 80 percent of obese adults currently suffer from line 15 type II diabetes, high blood cholesterol, high blood pressure, or line 16 other related conditions. 97 SB 1000— 3 — line 1 (c)  The medical costs for people who are obese are dramatically line 2 higher than those of normal weight. Overweight and obesity line 3 account for $147 billion in health care costs nationally, or 9 percent line 4 of all medical spending, with one-half these costs paid publicly line 5 through the Medicare and Medicaid programs. line 6 (d)  Health care costs and lost productivity resulting from line 7 overweight, obesity, and physical inactivity are estimated to cost line 8 California more than $52 billion annually. line 9 (e)  There is overwhelming evidence of the link between obesity line 10 and the consumption of sweetened beverages, such as soft drinks, line 11 energy drinks, sweet teas, and sports drinks. The 2010 Dietary line 12 Guidelines for Americans recommend that everyone reduce their line 13 intake of sugar-sweetened beverages. California adults who drink line 14 a soda or more per day are 27 percent more likely to be overweight line 15 or obese, regardless of income or ethnicity. line 16 (f)  Individuals who drink one to two sugar-sweetened beverages line 17 per day have a 26 percent higher risk for developing type II line 18 diabetes. Over the past 10 years, the percentage of teens nationwide line 19 that have diabetes or prediabetes has increased from 9 percent to line 20 23 percent. According to the American Diabetes Association, line 21 persons with type I diabetes should limit or avoid consumption of line 22 sugar-sweetened beverages. Complications of diabetes include: line 23 heart disease, nerve damage, gum infections, kidney disease, line 24 hearing impairment, blindness, amputation of toes, feet, or legs, line 25 and increased risk of Alzheimer’s disease. line 26 (g)  According to nutrition experts, sweetened beverages, such line 27 as soft drinks, energy drinks, sweet teas, and sports drinks, offer line 28 little or no nutritional value, but massive quantities of added sugars. line 29 A 20-ounce bottle of soda contains the equivalent of approximately line 30 17 teaspoons of sugar. Yet, the American Heart Association line 31 recommends that Americans consume no more than five to nine line 32 teaspoons of sugar per day. line 33 (h)  Sugar-sweetened beverages are the single largest source of line 34 added sugars in the American diet, with the average American line 35 drinking nearly 45 gallons of sweetened beverages a year, the line 36 equivalent of 39 pounds of extra sugar every year. Over 50 percent line 37 of the United States population drinks one or more sugar-sweetened line 38 beverages per day. line 39 (i)  In California, 19 percent of two to five year olds, inclusive, line 40 drink a sugar-sweetened beverage each day. That number climbs 97 — 4 —SB 1000 line 1 to 32 percent among 6 to 11 year olds, inclusive, and 65 percent line 2 among 12 to 17 year olds, inclusive. Additionally, major disparities line 3 now exist between races and ethnicities. Seventy-four percent of line 4 African American adolescents drink at least one sugar-sweetened line 5 beverage each day, compared to 73 percent of Latinos, 63 percent line 6 of Asians, and 56 percent of whites. line 7 (j)  Sugar-sweetened beverages are a unique contributor to excess line 8 caloric consumption. Research shows that calories from line 9 sugar-sweetened beverages do not satisfy hunger the way calories line 10 from solid food or fat or protein-containing beverages such as line 11 those containing milk and plant-based proteins. As a result, line 12 sugar-sweetened beverages tend to add to the calories people line 13 consume rather than replace them. line 14 (k)  Consistent evidence shows a positive relationship between line 15 sugar intake and dental caries (cavities) in adults and fewer caries line 16 when sugar intake is restricted. Children who frequently consume line 17 beverages high in sugar are at an increased risk for dental caries. line 18 Untreated dental caries can lead to pain, infection, tooth loss, and line 19 in severe cases, death. line 20 (l)  Evidence suggests that health warnings can increase line 21 knowledge and reduce consumption of harmful products. Studies line 22 show that prominent health warnings on the face of cigarette line 23 packages can increase health knowledge, perceptions of risk, and line 24 can promote smoking cessation of both youth and adults. line 25 SEC. 2. Article 15 (commencing with Section 111224) is added line 26 to Chapter 5 of Part 5 of Division 104 of the Health and Safety line 27 Code, to read: line 28 line 29 Article 15. Sugar-Sweetened Beverages Safety Warning Act line 30 line 31 111224. This article shall be known and may be cited as the line 32 Sugar-Sweetened Beverages Safety Warning Act. line 33 111224.05. It is the intent of the Legislature, by enacting this line 34 article, to protect consumers and to promote informed purchasing line 35 decisions by requiring a warning about the harmful health effects line 36 that result from the consumption of drinks with added sugars. line 37 111224.10. For purposes of this article, unless the context line 38 clearly requires otherwise, the following definitions shall apply: line 39 (a)  “Beverage container” means any sealed or unsealed container line 40 regardless of size or shape, including without limitation, those 97 SB 1000— 5 — line 1 made of glass, metal, paper, plastic, or any other material or line 2 combination of materials that is used or intended to be used to hold line 3 a sugar-sweetened beverage for individual sale to a consumer. line 4 (b)  “Beverage dispensing machine” means any device that mixes line 5 concentrate with any one or more other ingredients and dispenses line 6 the resulting mixture into an unsealed container as a ready-to-drink line 7 beverage. line 8 (c)  “Caloric sweetener” means any substance containing calories, line 9 suitable for human consumption, that humans perceive as sweet line 10 and includes, without limitation, sucrose, fructose, glucose, and line 11 other sugars and fruit juice concentrates. “Caloric” means a line 12 substance that adds calories to the diet of a person who consumes line 13 that substance. line 14 (d)  “Concentrate” means a syrup or powder that is used or line 15 intended to be used for mixing, compounding, or making a line 16 sugar-sweetened beverage. line 17 (e)  “Consumer” means a person who purchases a line 18 sugar-sweetened beverage for a purpose other than resale in the line 19 ordinary course of business. line 20 (f)  “Department” means the State Department of Public Health, line 21 and any agency or person lawfully designated by the department line 22 to enforce or implement this article. line 23 (g)  “Distribute” means to sell or otherwise provide a product line 24 to any person for resale in the ordinary course of business to a line 25 consumer within this state. line 26 (h)  “Natural fruit juice” means the original liquid resulting from line 27 the pressing of fruit, the liquid resulting from the reconstitution of line 28 natural fruit juice concentrate, or the liquid resulting from the line 29 restoration of water to dehydrated natural fruit juice. line 30 (i)  “Natural vegetable juice” means the original liquid resulting line 31 from the pressing of vegetables, the liquid resulting from the line 32 reconstitution of natural vegetable juice concentrate, or the liquid line 33 resulting from the restoration of water to dehydrated natural line 34 vegetable juice. line 35 (j)  “Person” means any natural person, partnership, cooperative line 36 association, limited liability company, corporation, personal line 37 representative, receiver, trustee, assignee, any other legal entity, line 38 any city, county, city and county, district, commission, the state, line 39 or any department, agency, or political subdivision thereof, any 97 — 6 —SB 1000 line 1 interstate body, and, to the extent permitted by federal law, the line 2 United States and its agencies and instrumentalities. line 3 (k)  “Powder” means a solid mixture with added caloric line 4 sweetener used in making, mixing, or compounding a line 5 sugar-sweetened beverage by mixing the powder with any one or line 6 more other ingredients, including, without limitation, water, ice, line 7 syrup, simple syrup, fruits, vegetables, fruit juice, or carbonation line 8 or other gas. line 9 (l)  “Sale” or “sell” means any distribution or transfer for a line 10 business purpose, whether or not consideration is received. line 11 (m)  “Sealed beverage container” means a beverage container line 12 holding a beverage that is closed or sealed before being offered line 13 for sale to a consumer. line 14 (n)  (1)  “Sugar-sweetened beverage” means any sweetened line 15 nonalcoholic beverage, carbonated or noncarbonated, sold for line 16 human consumption that has added caloric sweeteners and contains line 17 75 calories or more per 12 fluid ounces. “Nonalcoholic beverage” line 18 means any beverage that contains less than one-half of 1 percent line 19 alcohol per volume. line 20 (2)  “Sugar-sweetened beverage” does not include any of the line 21 following: line 22 (A)  Any beverage containing 100 percent natural fruit juice or line 23 natural vegetable juice with no added caloric sweeteners. line 24 (B)  Any liquid product manufactured for any of the following line 25 uses and commonly referred to as a “dietary aid”: line 26 (i)  An oral nutritional therapy for persons who cannot absorb line 27 or metabolize dietary nutrients from food or beverages. line 28 (ii)  A source of necessary nutrition used as a result of a medical line 29 condition. line 30 (iii)  An oral electrolyte solution for infants and children line 31 formulated to prevent dehydration due to illness. line 32 (C)  Any product for consumption by infants and that is line 33 commonly referred to as “infant formula.” line 34 (D)  Any beverage whose principal ingredient by weight is milk. line 35 “Milk” means (i) natural liquid milk, regardless of the animal line 36 source or butterfat content. source, plant source, or butterfat line 37 content, (ii) natural milk concentrate, whether or not reconstituted line 38 and regardless of animal source, plant source, or butterfat content, line 39 or (iii) dehydrated natural milk, whether or not reconstituted and line 40 regardless of animal source, plant source, or butterfat content. 97 SB 1000— 7 — line 1 (o)  “Syrup” means a liquid mixture with added caloric sweetener line 2 used in making, mixing, or compounding a sugar-sweetened line 3 beverage by mixing the syrup with any one or more other line 4 ingredients, including, without limitation, water, ice, a powder, line 5 simple syrup, fruits, vegetables, fruit juice, vegetable juice, or line 6 carbonation or other gas. line 7 (p)  “Unsealed beverage container” means a beverage container line 8 into which a beverage is dispensed or poured at the business line 9 premises where the beverage is purchased, including, without line 10 limitation, a container for fountain drinks. line 11 111224.15. (a)  A person shall not distribute, sell, or offer for line 12 sale a sugar-sweetened beverage in a sealed beverage container in line 13 this state unless the container bears the following safety warning line 14 and otherwise meets all of the requirements under this section: line 15 “STATE OF CALIFORNIA SAFETY WARNING: Drinking line 16 beverages with added sugar(s) contributes to obesity, diabetes, and line 17 tooth decay.” line 18 (b)  (1)  The safety warning required by subdivision (a) shall be line 19 prominently displayed and readily legible under ordinary conditions line 20 on the front of the sealed beverage container, separate and apart line 21 from all other information, and shall be on a contrasting line 22 background. The first five words of the safety warning required line 23 under subdivision (a), “STATE OF CALIFORNIA SAFETY line 24 WARNING” shall appear in capital letters. The entire safety line 25 warning shall appear in bold type. line 26 (2)  Size of type and number of characters. The safety warning line 27 required under subdivision (a) shall appear in a font size and in a line 28 maximum number of characters (i.e., letters, numbers, and marks) line 29 per inch, as follows: line 30 (A)  For beverage containers of 8 fluid ounces or less, the safety line 31 warning shall be in script, type, or printing not smaller than 1 line 32 millimeter, and there shall be no more than 40 characters per linear line 33 inch. line 34 (B)  For beverage containers of more than 8 fluid ounces and line 35 less than 1 liter, the safety warning shall be in script, type, or line 36 printing not smaller than 2 millimeters, and there shall be no more line 37 than 25 characters per linear inch. line 38 (C)  For beverage containers of 1 liter or more, the safety warning line 39 shall be in script, type, or printing not smaller than 3 millimeters, line 40 and there shall be no more than 12 characters per linear inch. 97 — 8 —SB 1000 line 1 (c)  If the safety warning required under subdivision (a) is not line 2 printed directly on the beverage container, the safety warning shall line 3 be affixed to the beverage container in such a manner that it cannot line 4 be removed without thorough application of water or other solvents. line 5 (d)  A person shall not distribute, sell, or offer for sale a line 6 multipack of sugar-sweetened beverages in sealed beverage line 7 containers in this state unless the multipack of beverages bears the line 8 safety warning required under subdivision (a). The safety warning line 9 shall be posted conspicuously on each side at least two sides of line 10 the multipack, in addition to being posted on each individual sealed line 11 beverage container. line 12 (e)  A person shall not distribute, sell, or offer for sale a line 13 concentrate in this state unless the packaging of the concentrate, line 14 which is intended for retail sale, bears the safety warning required line 15 under subdivision (a). The safety warning shall be posted line 16 conspicuously on the front of the packaging of the concentrate. line 17 111224.20. (a)  Every person who owns, leases, or otherwise line 18 legally controls the premises where a vending machine or beverage line 19 dispensing machine is located, or where a sugar-sweetened line 20 beverage is sold in an unsealed beverage container, shall place, or line 21 cause to be placed, a safety warning in each of the following line 22 locations: line 23 (1)  On the exterior of any vending machine that includes a line 24 sugar-sweetened beverage for sale. line 25 (2)  On the exterior of any beverage dispensing machine used line 26 by a consumer to dispense a sugar-sweetened beverage through line 27 self-service. line 28 (3)  At the point-of-purchase where any consumer purchases a line 29 sugar-sweetened beverage in an unsealed beverage container, when line 30 the unsealed beverage container is filled by an employee of a food line 31 establishment rather than the consumer. line 32 (b)  The safety warning required by subdivision (a) shall contain line 33 the following language: line 34 “STATE OF CALIFORNIA SAFETY WARNING: Drinking line 35 beverages with added sugar(s) contributes to obesity, diabetes, and line 36 tooth decay.” line 37 (c)  The safety warning required by subdivision (a) shall be line 38 prominently displayed and readily legible under ordinary line 39 conditions, separate and apart from all other information, and shall line 40 be on a contrasting background. The first five words of the safety 97 SB 1000— 9 — line 1 warning in subdivision (b), “STATE OF CALIFORNIA SAFETY line 2 WARNING” shall appear in capital letters. The entire safety line 3 warning shall appear in bold type. line 4 111224.25. Every person that distributes, sells, or offers for line 5 retail sale a sugar-sweetened beverage shall maintain on its line 6 business premises, for a period of two years following each line 7 distribution, purchase, or sale, all records, including, legible line 8 invoices and purchase orders, as may be necessary to determine line 9 the quantity and type of sugar-sweetened beverages distributed, line 10 purchased, or sold. The department and a local enforcement agency line 11 shall have the right to inspect, examine, and copy those records at line 12 any time during normal business hours for the purpose of ensuring line 13 compliance by distributors with the requirements of this article. line 14 The refusal to allow a full inspection, examination, or copying of line 15 those records shall constitute a violation of this article. line 16 111224.30. (a)  Notwithstanding Section 111825, subdivision line 17 (b) of Section 111855, or any other law, commencing July 1, 2015, line 18 any violation of this article, or a regulation adopted pursuant to line 19 this article, is punishable by a civil penalty of not less than fifty line 20 dollars ($50), but no greater than five hundred dollars ($500). The line 21 department or a local enforcement agency may assess the civil line 22 penalty according to the procedures set forth in Section 111855. line 23 A person shall not be found to violate this article more than once line 24 during any one inspection visit. line 25 (b)  There is hereby created in the State Treasury the line 26 Sugar-Sweetened Beverages Safety Warning Fund. The fund shall line 27 consist of moneys collected for the violation of this article. The line 28 department and local enforcement agencies shall remit to the line 29 Treasurer any civil penalties collected pursuant to subdivision (a) line 30 on a biannual basis, no later than March 15 and September 15 of line 31 each year. Notwithstanding any other law, moneys in the fund, line 32 upon appropriation by the Legislature, shall be allocated to local line 33 enforcement agencies for the purpose of enforcing this article. line 34 111224.35. The department shall adopt regulations for the line 35 implementation of this article in accordance with the line 36 Administrative Procedure Act (Chapter 3.5 (commencing with line 37 Section 11340) of Part 1 of Division 3 of Title 2 of the Government line 38 Code). Notwithstanding Section 111224.15 or 111224.20, if, after line 39 appropriate investigation and consultation with the state health line 40 officer, the department finds that available scientific information 97 — 10 —SB 1000 line 1 would justify a change in the language of the safety warnings set line 2 forth in Sections 111224.15 and 111224.20, the department may line 3 adopt regulations to develop new language for the safety warning line 4 and may require that the alternative language be adopted in lieu line 5 of the language set forth in Sections 111224.15 and 111224.20. line 6 111224.40. It is the intent of the Legislature that nothing in line 7 this article shall be construed to preempt or prohibit the adoption line 8 and implementation of local ordinances related to sugar-sweetened line 9 beverages, except any local ordinance requiring a safety warning line 10 to be placed on a sugar-sweetened beverage container that is line 11 inconsistent with this article. An ordinance is not deemed line 12 inconsistent with this article if it affords greater protection than line 13 the requirements set forth in this article. line 14 SEC. 3. The provisions of this act are severable. If any line 15 provision of this act or its application is held invalid, that invalidity line 16 shall not affect other provisions or applications that can be given line 17 effect without the invalid provision or application. line 18 SEC. 4. If the Commission on State Mandates determines that line 19 this act contains costs mandated by the state, reimbursement to line 20 local agencies and school districts for those costs shall be made line 21 pursuant to Part 7 (commencing with Section 17500) of Division line 22 4 of Title 2 of the Government Code. O 97 SB 1000— 11 — 1615 Capitol Ave., Suite 73.771 PHONE: 916.440.7594 Roberta Lawson P.O. Box 997377, MS 7003 FAX: 916.440.7595 RDH, MPH Sacramento, CA 95899-7377 Roberta.Lawson@cdph.ca.gov Executive Administrator http://www.cclho.org Officers Muntu Davis, MD, MPH President Alameda County Karen Smith, MD, MPH President-Elect Napa County Bela Matyas, MD, MPH Treasurer Solano County Eric Handler, MD, MPH Secretary Orange County Janet Berreman, MD, MPH Legislative Coordinator City of Berkeley S. Todd Stolp, MD Regulations Coordinator Tuolumne County Wilma Wooten, MD, MPH Past President San Diego County Directors-at-Large Kenneth Cutler, MD, MPH Sierra/Trinity Counties Olivia Kasirye, MD, MPH Sacramento County Cameron Kaiser, MD Riverside County Mark Lundberg, MD, MPH Butte County Edward Moreno, MD, MPH Monterey County Maxwell Ohikhuare, MD San Bernardino County Matthew Willis, MD, MPH Marin County March 20, 2014 Ron Chapman, MD, MPH, Director California Department of Public Health 1615 Capitol Avenue, Suite 73.770 PO Box 997377, MS 0500 Sacramento, CA 95899-7377 RE: SB 1000 (Monning) Public health: sugar-sweetened beverages: safety warnings Dear Dr. Chapman: As you know, the California Conference of Local Health Officers (CCLHO) is an organization of all legally appointed physician health officers in California’s 61 city and county jurisdictions established in statute in 1947 to consult with, advise, and make recommendations to the California Department of Public Health, other departments, boards, commissions and officials of federal, state, and local government, the Legislature, and any other organization or association on matters affecting health. On March 6, 2014, the CCLHO Board voted to take a support position on SB 1000, a bill by Senator Monning calling for the use of safety warnings on sugary beverages as a mechanism to prevent obesity, diabetes and tooth decay. CCLHO urges the California Department of Public Health (CDPH) to also support this legislation. The prevalence of obesity in the United States with its associated health problems has increased dramatically over the past 30 years. Today, nearly 40% of California children are either overweight or obese – the highest in history. These children have a much greater likelihood of going on to become obese as adults, so we can anticipate that the adult obesity rates will continue to climb. . Sugar beverages are the largest single cause of childhood obesity. Drinking one sugary beverage a day increases the chances for a child to become overweight by 55%. California adults who drink one soda or more per day are 27 percent more likely to be overweight or obese, and individuals who drink one to two sugar-sweetened beverages per day have a 26 percent higher risk for developing type II diabetes. We know that adults and parents have the responsibility to make good choices for themselves and their families. However, people need reliable information to make good decisions and an environment that supports making healthy choices. SB 1000 would provide both by requiring a warning label on the front or all cans and bottles of soda and fruit drinks with added sweeteners that have 75 or more calories per 12 ounces. This warning will allow consumers to make purchasing choices informed by the latest scientific evidence. Senate Bill 1000 is a major step forward in the fight against California’s obesity and diabetes epidemic. It will protect consumers and promote informed purchasing decisions by requiring a warning about the harmful effects of consuming beverages with added sugars. We know from the successful tobacco control work in our state that health warnings can increase knowledge and perception of risk, and SB 1000 can make a major contribution to improving community health in California. If you have questions, please contact me at Muntu.davis@acgov.org or 510-267-8010. Thank you. Sincerely