104350. (a) The Legislature finds and declares as follows:
(1) Smoking is the single most important source of preventable
disease and premature death in California.
(2) More than 30 percent of coronary heart disease cases are
attributable to cigarette smoking.
(3) More than 30 percent of all annual cancer deaths are
attributable to smoking, with lung cancer now the leading cancer
killer in women as well as men.
(4) Smoking is responsible for one-quarter of all deaths caused by
fire.
(5) Involuntary smoking is a cause of disease, including lung
cancer, in healthy nonsmokers.
(6) More than 80 percent of chronic obstructive lung diseases
including emphysema and chronic bronchitis are attributable to
smoking.
(7) Tobacco-related disease places a tremendous financial burden
upon the persons with the disease, their families, the health care
delivery system, and society as a whole. California spends five
billion six hundred million dollars ($5,600,000,000) a year in direct
and indirect costs on smoking-related illnesses.
(8) The elimination of smoking is the number one weapon against
four of the five leading causes of death in California.
(9) Keeping children and young adults from beginning to use
tobacco and encouraging all persons to quit tobacco use shall be the
highest priority in disease prevention for the State of California.
More than 60 percent of all smokers begin smoking by the age of 14,
and 90 percent begin by the age of 19.
(10) The State of California shall play a leading role in
promoting a smoke-free society by the year 2000 and thereby
supporting the National Health Status Objectives for the year 2000
relating to smoking and tobacco use.
(b) It is the intent of the Legislature, therefore, to require the
department, local lead agencies, and the State Department of
Education to cooperatively and individually conduct activities
directed at the prevention of tobacco use and tobacco-related
diseases. The campaign shall focus on health promotion, disease
prevention, and risk reduction, utilizing a "wellness" perspective
that encourages self-esteem and positive decisionmaking techniques.
It is also the intent of the Legislature that, for the purpose of
program planning and program evaluation, the department provide data
and technical information on tobacco-related diseases, tobacco use
and its consequences, and effective personal and community
interventions to prevent tobacco use.
104355. The following definitions shall apply to this article:
(a) "Grantee" means any public or private nonprofit entity
approved by the department or the State Department of Education to
receive funds pursuant to this article. Grantees may include, but are
not limited to, hospitals, community clinics, local health
departments, voluntary health organizations, Indian tribes, colleges
and universities, county offices of education, school districts,
health maintenance organizations, professional health associations,
and professional health education associations.
(b) "Tobacco-related disease" means any of the following:
(1) Coronary heart disease.
(2) Cerebrovascular disease.
(3) Cancer, including cancers of the lung, larynx, esophagus,
bladder, pancreas, and mouth.
(4) Chronic obstructive lung diseases, including emphysema,
chronic bronchitis, asthma, and related lung disorders.
(5) Conditions where smoking or tobacco use has been determined to
be a risk factor for excess disability and illness, including burns
due to smoking-related fires.
(c) "Tobacco use" means the consumption of tobacco products by
burning, chewing, inhalation, or other forms of ingestion.
(d) "Voluntary health organization" means a nonprofit organization
organized for purposes related to health, including, but not limited
to, an organization devoted to the research of cancer, heart
disease, or diseases of the lung.
(e) "Committee" means the Tobacco Education Oversight Committee.
(f) "The department" means the State Department of Health
Services.
(g) "Service provider" means an agency or organization that enters
into an agreement with the local lead agency or state department to
provide services under this article.
(h) "Direct services" means the provision of preventive health
education services to targeted populations.
(i) "Local plan" means a plan submitted pursuant to Section
104400.
(j) "Preventive health education against tobacco use" means
programs of instruction intended to dissuade individuals from
beginning to smoke, to encourage smoking cessation, or to provide
information on the health effects of tobacco on the user, children,
and nonsmokers. These programs may include a focus on health
promotion, disease prevention, and risk reduction, utilizing a
"wellness perspective" that encourages self-esteem and positive
decisionmaking techniques.
(k) "Targeted populations" means those population groups specified
in Sections 104360 and 104385.
( l) "Local lead agencies" means those agencies designated as
local lead agencies pursuant to Section 104400.
104360. The following target populations, at a minimum, shall be
the focus of the campaign implemented pursuant to this article:
(a) School-age youth and their families in the schools and in the
community.
(b) Black, Hispanic, Native American, and Asian-Pacific American
populations, pregnant women, and current smokers.
104365. (a) There is hereby created the Tobacco Education and
Research Oversight Committee in state government that shall advise
the department and the State Department of Education with respect to
policy development, integration, and evaluation of tobacco education
programs funded under this article, and for development of a master
plan for the future implementation of tobacco education programs.
(b) The Tobacco Education Oversight Committee shall be composed of
13 members to be appointed as follows:
(1) Two members representing volunteer health organizations
dedicated to the reduction of tobacco use appointed by the Speaker of
the Assembly.
(2) One member representing an organization that represents health
care employees appointed by the Senate Rules Committee.
(3) One member of a professional education association, such as an
association of teachers, appointed by the Senate Rules Committee.
(4) One member of a university facility with expertise in programs
intended to reduce tobacco use appointed by the Governor.
(5) Two representatives of a target population group appointed by
the Governor.
(6) One representative of the department appointed by the
Governor.
(7) One representative of the State Department of Education
appointed by the Superintendent of Public Instruction.
(8) One member representing the interests of the general public
appointed by the Governor.
(9) One representative of local health departments appointed by
the Governor.
(10) One member representing a volunteer health organization
dedicated to the reduction of tobacco associated injury appointed by
the Governor.
(11) One member from the Tobacco Related Disease Research Program
appointed by the Governor.
(c) Members shall serve for a term of two years, renewable at the
option of the appointing authority. The initial appointments of
members shall be for two or three years, to be drawn by random lot at
the first meeting. The committee shall be staffed by the department'
s coordinator of the program created pursuant to Section 104375.
(d) The committee shall meet as often as it deems necessary, but
shall meet not less than four times per year.
(e) The members of the committee shall serve without compensation,
but shall be reimbursed for necessary travel expenses incurred in
the performance of the duties of the committee.
104370. The committee shall be advisory to the department, the
University of California, and State Department of Education for the
following purposes:
(a) Evaluation of research, school- and community-based programs
funded under this article as necessary in order to assess the overall
effectiveness of efforts made by the programs to reduce the use of
tobacco products. In order to evaluate tobacco education, research,
and cessation programs, the committee shall seek the cooperation and
assistance of the department, the State Department of Education,
county offices of education, local lead agencies, administrative
representatives, target populations, school officials, and
researchers. A principal measurement of effectiveness shall be
reduction of smoking rates among a given target population.
(b) Facilitation of programs directed at reducing and eliminating
tobacco use that are operated jointly by more than one agency or
entity. The committee shall propose strategies for the coordination
of proposed programs administered by the department, the University
of California, and the State Department of Education in order to
avoid the duplication of services and to maximize the public benefit
of the programs.
(c) Make recommendations to the department, the University of
California, and the State Department of Education regarding the most
appropriate criteria for the selection of, standards of the operation
of, and the types of programs to be funded under this article.
(d) Reporting to the Legislature on or before January 1 of each
year on the number and amount of tobacco education programs funded by
the Health Education Account, created by Section 30122 of the
Revenue and Taxation Code, the amount of money in the account, any
moneys previously appropriated to the department, the University of
California, and the State Department of Education but unspent by the
departments, a description and assessment of all programs funded
under this article, and recommendations for any necessary policy
changes or improvements for tobacco education programs.
(e) Ensuring that the most current research findings regarding
tobacco use prevention are applied in designing the tobacco education
programs administered by the department and the State Department of
Education. The department and the State Department of Education shall
apply the most current findings and recommendations of research
including research funded by the Research Account of the Cigarette
and Tobacco Products Surtax Fund created by Section 30122 of the
Revenue and Taxation Code.
(f) Based on the results of programs supported by this article and
any other proven methodologies available to the committee, produce a
comprehensive master plan for implementing tobacco education
programs throughout this state for the prevention and cessation of
tobacco use. The master plan shall include implementation strategies
for each target population specified in Section 104360 for programs
throughout this state. The Tobacco Education and Research Oversight
Committee shall submit the master plan to the Legislature biennially.
The master plan and its revisions shall include recommendations on
administrative arrangements, funding priorities, integration and
coordination of approaches by the department, the University of
California, and the State Department of Education and their support
systems, as well as progress reports relating to each target
population. The master plan shall establish a goal of achieving a
75-percent reduction in tobacco consumption in California by the year
1999.
104375. (a) To prevent tobacco-related diseases and diminish
tobacco use, the department shall establish within the department a
program on tobacco use and health to reduce tobacco use in California
by conducting health education interventions and behavior change
programs at the state level, in the community, and other nonschool
settings.
(b) The department shall conduct statewide surveillance of
tobacco-related behaviors, knowledge, and attitudes and evaluate the
department's local and state tobacco control programs under this
article. At a minimum, these evaluation activities shall utilize
scientifically appropriate methods for monitoring the annual progress
of the program in reducing the adult smoking prevalence from the
1993 benchmark rate of 20 percent and reducing cigarette consumption
from the 1993 per capita benchmark rate of 4.84 packs per quarter.
These surveillance and evaluation activities may include, but need
not be limited to, the following:
(1) Be based on sound evaluation principles and include, to the
extent feasible, elements of controlled experimental methods.
(2) Monitor the overall statewide effect of health education
efforts on smoking and tobacco use, and, to the extent feasible, the
resulting effects on health.
(3) Monitor the effect of the programs on individual target
populations identified by this article or designated by the
department as meriting special attention.
(4) Provide an evaluation of the comparative effectiveness of
individual program designs that shall be used in funding decisions
and program modifications.
(5) Incorporate other aspects into the evaluation that have been
identified by the department in consultation with state and local
advisory groups, local lead agencies, and other interested parties.
(6) Funds permitting, utilize a sample size that is adequate to
produce county, regional, and ethnic specific estimates.
(c) The department shall produce or contract for, and update
biennially, a description of programs determined to be effective in
reducing smoking and tobacco use, and the identification of portions
of target populations that need information regarding the hazards of
tobacco use. The department, in consultation with the State
Department of Education, shall conduct, or contract for an evaluation
of the effectiveness of the tobacco use prevention and education
program as implemented in the public schools that receive funding for
tobacco use prevention education pursuant to Sections 104420,
104425, 104435, and 104445. The purpose of the evaluation shall be to
direct the most efficient allocation of resources appropriated under
this article to accomplish the maximum prevention and reduction of
tobacco use. The comprehensive evaluation shall be designed to
measure the extent to which programs funded pursuant to this article
promote the goals identified in this article and in Proposition 99 of
the November 1988 general election. All information resulting from
the evaluation shall be made available to the State Department of
Education for purposes of improving its ability to implement and
oversee the provision of effective tobacco use prevention education
programs. The evaluator shall:
(1) Assess the effectiveness of tobacco use prevention education
programs designed to prevent and reduce tobacco use among students.
In support of this primary goal, the evaluation shall:
(A) Report findings on the effectiveness of programs and
strategies currently in use in California schools that prevent and
reduce tobacco use.
(B) Select a research strategy that will identify formal and
informal factors that might account for differences in tobacco use by
students, including, but not limited to, formal education prevention
strategies.
(C) Incorporate in the evaluation quantitative as well as
qualitative data. The data shall include, but are not limited to:
(i) Student data, including attitudes, knowledge, and behavior
based upon a statistically valid random sample of school districts
and students.
(ii) Curriculum data, including diversity of curricula, evidence
of appropriateness to grade level, gender, and ethnicity, and the
extent of the inclusion of prevention approaches identified in
research literature.
(iii) School data, including intensity of emphasis on tobacco use
prevention and evidence of counseling or treatment referral systems.
(iv) Community data, including the existence of parent networks
and the participation of community service organizations including
local lead agencies, in prevention.
(2) Develop and test a regular tobacco use prevention and
education information system for use by the State Department of
Education, using the resulting information to establish the extent of
implementation of tobacco use prevention education programs
statewide and the degree of student exposure to these programs at
selected grade levels.
(3) Ensure provision of a fourth administration of a statewide,
biennial survey of attitudes toward tobacco and prevalence of tobacco
use among public school students. To the extent possible, existing
survey data shall be utilized.
(4) Provide recommendations to the Legislature and the State
Department of Education on tobacco use prevention education program
changes.
(5) Assist the State Department of Education in identifying and
developing instructional materials and curricula in school-based
programs, designed to enhance the prevention of and encouraging the
cessation of the continuing use of, tobacco products. The materials
and curricula shall address the specific needs of persons in grades 4
to 12, inclusive, and in adult education programs.
(d) School districts shall agree, as a condition of receiving
money pursuant to this article, to participate in the evaluation if
chosen by the evaluator.
(e) (1) The department shall contract with one or more qualified
agencies for production and implementation of an ongoing public
awareness of tobacco-related diseases by developing an information
campaign using a variety of media approaches. The department shall
issue a request for proposals biennially. Any media campaign funded
with this part shall stress the importance of both preventing the
initiation of tobacco use and quitting smoking and shall be based on
professional market research and surveys necessary to determine the
most effective method of diminishing tobacco use among specified
target populations. Initial media efforts shall be directed to
specific target populations. The contractors selected shall be
provided with all available survey information resulting from ongoing
programs funded under this article. Priority shall be given to minor
children, ages 6 to 14, inclusive. The medium used shall be
determined to be the most effective at reaching this targeted age
group. With respect to the broadcast media, the message shall be
aired at times expected to reach the priority age group. With respect
to the print media, publications to be used shall be those that
appeal to the priority age group.
(2) No media campaign funded pursuant to this article shall
feature in any manner the image or voice of any elected public
official or candidate for elected office, or directly represent the
views of any elected public official or candidate for elected office.
(f) The department shall provide or contract for training,
consultation, support, and continuing education to health
professionals, and others interested in developing programs and
services directed at preventing tobacco use and promoting smoking
cessation, utilizing, when available and determined appropriate by
the department, the expertise of universities in this state and
schools of public health. The training, consultation, support, and
continuing education shall include advice and support in creating a
smoke-free environment.
(g) The department shall conduct an awards program to acknowledge
the outstanding achievements of those communities, organizations, and
groups that have fostered movement toward a smoke-free society or
have reduced the consumption of tobacco.
(h) The department shall issue guidelines for local plans for
education against tobacco use. The guidelines shall require local
public health departments to provide services directed at preventing
tobacco use and promoting smoking cessation to the target populations
enumerated in Section 104360 and to persons under 19 years of age
who no longer attend school and to youth attending school who are not
served through State Department of Education funded programs. The
guidelines shall require for each target population to be served a
description of the services to be provided, an estimate of the number
to be served, an estimate of the success rate, and a method to
determine to what extent goals have been achieved. Beginning with the
1990-91 fiscal year, and for each fiscal year thereafter, the
guidelines shall require local lead agencies to describe how local
funding decisions will take into account evaluations of program
effectiveness and efficiency. The guidelines shall require the
submission of a budget and information on staffing configurations.
(i) By December 31, 1989, the department shall issue guidelines
for fiscal year 1989-90 and by July 1, 1990, the department shall
issue guidelines to local lead agencies on how to prepare a local
plan for a comprehensive community intervention program against
tobacco use.
(j) The department shall provide technical assistance to local
lead agencies for the development of plans required by Section 104400
so that the local lead agencies are able to comply with the schedule
for the submission of plans specified in Section 104400. The
technical assistance shall include, but not be limited to, the
following:
(1) Developing and disseminating preventive health education
program options for local communities.
(2) Providing training, consultation, and technical assistance to
local health departments, local advisory committees, and service
providers.
(k) The department shall receive and approve local plans submitted
by local lead agencies and provide technical assistance and guidance
as necessary to ensure the compliance of the local lead agencies
with this article. Every effort shall be made to approve or provide a
list of necessary amendments to a local plan within 30 days of
receipt of the local plan. The department may authorize a local lead
agency to begin implementation of its local plan on a provisional
basis, with final approval of the local plan contingent on satisfying
conditions specified by the department.
( l) The department shall work in collaboration with the public
and private sectors in implementing the activities required of the
department and provide access upon request to local plans, program
statistics, and other readily available information.
(m) The department shall provide staff, assistance, and support
needed by the committee.
(n) In consultation with the committee, the department shall
develop a comprehensive master plan for implementing tobacco
education programs throughout the state for the prevention and
cessation of tobacco use.
(o) The department shall consult regularly with the University of
California regarding trends in the frequency and the cost of treating
tobacco-related diseases and the success of research efforts to
reduce tobacco use and limit its adverse health effects.
(p) The department shall establish, in consultation with the State
Department of Education and county offices of education, a data
collection and data management program to study effective tobacco use
interventions. Under this program the department may contract for
studies and evaluations in school-based and community-based programs.
The department shall consult with the State Department of Education
regarding the collection and evaluation of program data.
(1) The department shall require, by contract, that local lead
agencies use a uniform management data and information system that
will permit comparisons of workload, unit costs, and outcome
measurements on a statewide basis. The department shall specify data
reporting requirements for local lead agencies and their
subcontractors.
(2) The department shall approve local lead agency and grantee
computer software and hardware in order to ensure systemwide
compatibility and capacity to expand. Departmental guidelines for
local plans shall require local lead agencies to set forth their
hardware and software plans and needs.
(3) The department may contract for the development or operation
of a computerized management information system.
(4) The department shall consult the State Department of Education
regarding computer software and hardware systems for school-based
programs.
104380. (a) Funds appropriated to the department for local lead
agencies for purposes of this article shall be allocated
prospectively, on a quarterly basis in accordance with this section.
(b) No local lead agency shall be allocated less than one hundred
fifty thousand dollars ($150,000).
(c) (1) Except as provided in subdivision (b), counties not listed
in subdivision (d) shall receive an allocation based on each county'
s proportion of the statewide population.
(2) Counties that receive their allocations pursuant to paragraph
(1) shall receive 73 percent of their 1990-91 fiscal year allocation.
(d) Except as provided in subdivision (b), the balance of the
funds after the allocation contained in subdivision (c) have been
made, shall be allocated to the following specified counties in
accordance with the following percentages:
COUNTY ALLOCATION
Alameda 4.7427%
Contra Costa 1.8032%
Fresno 2.6855%
Kern 1.7083%
Lake 0.1826%
Los Angeles 43.8057%
Mendocino 0.2664%
Merced 0.7244%
Monterey 1.2937%
Orange 5.1382%
Placer 0.3697%
Riverside 3.1828%
Sacramento 3.2922%
San Bernardino 3.7972%
San Diego 5.9971%
San Francisco 5.3898%
San Joaquin 1.7413%
San Luis Obispo 0.8096%
San Mateo 1.4582%
Santa Barbara 0.7918%
Santa Clara 5.2450%
Santa Cruz 0.7709%
Stanislaus 1.2793%
Tulare 1.3768%
Ventura 1.5472%
Yolo 0.6004%
(e) Except as provided in subdivision (b), the allocation for
those counties in which a city health department which is a local
lead agency as defined by subdivision ( l) of Section 104355 is
located shall be apportioned among the local lead agencies in that
county based on their jurisdiction's proportionate share of the
countywide population.
(f) Reductions in allocations necessary to comply with subdivision
(b) shall be distributed among the counties listed in subdivision
(d) proportionately based on the table contained in subdivision (d).
(g) The department shall use population estimates for 1989 for
each county and for each city as specified in the Department of
Finance E-1 Report.
(h) Payments shall be made prospectively, on a quarterly basis, to
local jurisdictions.
(i) (1) The department shall conduct a fiscal and program review
on a regular basis.
(2) If the department determines that any county is not in
compliance with any provision of this chapter, the county shall
submit to the department, within 60 days, a plan for complying with
this article.
(3) The department may withhold funds from local lead agencies
allocated funds under this section that are not in compliance with
this chapter in the same manner as the department is authorized under
Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9
of the Welfare and Institutions Code. The department may terminate
the agreement with the noncompliant local lead agency, recoup any
unexpended funds from the noncompliant local lead agency, and
reallocate both the withheld and recouped funds to provide services
available under this section to the jurisdiction of the noncompliant
agency through an agreement with a different governmental or private
nonprofit agency capable of delivering those services based on the
department's local lead agency guidelines for local plans and a
process determined by the department. The department may encumber and
reallocate these funds no sooner than three months after the date of
the first notification that the department has determined the local
lead agency to be out of compliance with statutory requirements.
104385. (a) The department shall award and administer grants for
projects directed at the prevention of tobacco-related diseases. The
purpose of the grant program is to conduct health education and
promotion activities targeted to high-risk persons and groups in
order to reduce the number of persons beginning to use tobacco,
continuing to use tobacco, or developing tobacco-related diseases.
The grants shall provide funds to eligible grantees, as determined by
the department. In awarding grants, the department shall select a
variety of projects and grantees.
(b) The department shall develop criteria and standards for the
allocation of grant awards which consider the need to balance target
populations to be served, project types of rural suburban and urban
projects, and consider the current regional availability of similar
services. Target populations may include, but not be limited to,
children, young adults, pregnant women, low-income individuals,
Black, Hispanic, Native American, and Asian-Pacific Islander
populations, current smokers, and schoolaged youth no longer
attending school classes. The grant awards may also be made to school
districts for nonclassroom, districtwide efforts to reduce tobacco
use. The department shall develop mechanisms to evaluate all programs
and shall require any program funded under this article to provide
statistics on the impact of the program.
(c) The department shall give priority to grantees who do the
following:
(1) Demonstrate community support for the project.
(2) Design the project to coordinate with other community services
including local health programs, school-based programs, or voluntary
health organizations.
(3) Design the project to utilize and enhance existing services
and resources.
(4) Serve a target population at high risk of starting tobacco use
or developing tobacco-related illnesses.
(5) Demonstrate an understanding of the role community norms have
in influencing behavioral change regarding tobacco use.
(6) Indicate promising innovative approaches to diminishing
tobacco use among target groups and permit those approaches to be
replicated by others.
(d) Of the funds appropriated to the department in Item
4260-111-231 of the 1996 Budget Act, five million dollars
($5,000,000) shall be available specifically for grants awarded on a
competitive basis to provide smoking cessation classes or services
for persons eligible for and enrolled in the state's Medi-Cal
program, or persons who are medically indigent.
104390. (a) The department may provide program support services to
local tobacco use prevention programs, that shall include, but need
not be limited to, all of the following:
(1) Data collection.
(2) Educational materials.
(3) Evaluation.
(4) Technical assistance.
(5) Training.
(6) Transfer of information among programs.
(b) Services funded under this section may be awarded through a
competitive request for proposal process or directly to another state
agency, the Regents of the University of California, the federal
government, or an auxiliary organization of the California State
University.
(c) Grantees of services under this section shall demonstrate the
ability to do both of the following:
(1) Improve the delivery of local tobacco use prevention programs
directed at the targeted populations.
(2) Design programs to provide statewide and regional services to
support local implementation of tobacco use prevention programs.
104395. The department shall expand the Child Health and Disability
Prevention (CHDP) Program contained in Article 6 (commencing with
Section 124025) of Chapter 3 of Part 2 of Division 106 as follows:
(a) Any child between birth and 90 days after entrance into first
grade, all persons under 21 years of age who are eligible for the
California Medical Assistance Program, and any person under 19 years
of age whose family income is not more than 200 percent of the
federal poverty level shall be eligible for services under the
program in the county of which they are a resident. The department
shall adopt regulations specifying which age groups shall be given
certain types of screening tests and recommendations for referral.
(b) The first source of referral under the program shall be the
child's usual source of health care. If referral is required and no
regular source of health care can be identified, the facility or
provider providing health screening and evaluation services shall
provide a list of three qualified sources of care, without prejudice
for or against any specific source.
(c) The department shall issue protocols for an antitobacco
education component of the child health and disability prevention
medical examination. The protocols shall include the following:
dissuading children from beginning to smoke, encouraging smoking
cessation, and providing information on the health effects of tobacco
use on the user, children, and nonsmokers. The protocols shall also
include a focus on health promotion, disease prevention, and risk
reduction, utilizing a "wellness" perspective that encourages
self-esteem and positive decisionmaking techniques, and referral to
an appropriate community smoking cessation program.
(d) Notwithstanding any other provision of law, the department
shall ensure that a portion of the funds in the Child Health
Disability Prevention Program budget is used to facilitate the
integration of the medical and dental components of all aspects of
that program.
(e) The department shall expand its support and monitoring of
county child health and disability prevention program efforts to
provide all of the following:
(1) Review of a representative, statistically valid, randomly
selected sample of child health and disability prevention health
assessments, including, but not limited to, dental assessments, which
result in the discovery of conditions which require followup
diagnosis and treatment, including but not limited to dental
treatment, and which qualify for services under this section. The
purpose of the survey and followup reviews of local programs is to
determine whether necessary diagnosis and treatment services are
being provided, and the degree to which those services comply with
the intent of the act that added this subdivision. These survey
reviews shall include all counties and shall be conducted at least
three times a year.
(2) At least once a year, as part of regular visits to county
child health and disability prevention programs to provide technical
assistance, support services and monitoring and evaluation of program
performance, department staff shall review the effectiveness of the
mandated treatment program. The purpose of this review is to assure
that the county is providing appropriate followup services for
conditions discovered during child health and disability prevention
health assessments. This review shall be done in conjunction with the
ongoing survey activity of the Child Health and Disability
Prevention Branch of the department and shall utilize data resulting
from that activity.
(3) If the department establishes that a county has failed to
provide treatment services mandated by the act that added this
subdivision, the department shall require the county to submit a plan
of correction within 90 days. If the department finds that
substantial correction has not occurred within 90 days following
receipt of the correction plan, it may require the county to enter
into a contract pursuant to Section 16934.5 of the Welfare and
Institutions Code for the remainder of the fiscal year and the
following fiscal year, and for this purpose shall withhold the same
percentage of funds as are withheld from other counties participating
in the program pursuant to Section 16934.5 of the Welfare and
Institutions Code.
104400. (a) (1) Except as provided in paragraph (2), each county
health department or city health department as provided in Section
16800 of the Welfare and Institutions Code shall be the lead local
agency for its county. The local lead agency shall have the overall
responsibility for the success of the programs funded pursuant to
this article in its county.
(2) Counties contracting with the department for the provision of
health care services pursuant to Section 16809 of the Welfare and
Institutions Code may elect to enter into an arrangement with the
department for the administration and provision of funds and services
subject to this article in their counties. In those cases, the
department shall act as the local lead agency for that county.
(b) The local lead agency shall do all of the following:
(1) Provide, or contract for, preventive health education against
tobacco services to targeted populations.
(2) Establish a coordinated information, referral, outreach, and
intake system for preventive health education against tobacco
services for targeted populations.
(3) Administer funds in accordance with this article, and
department guidelines.
(4) Establish a uniform data collection system in compliance with
standards and guidelines issued by the department, and submit audit
and fiscal reports as required by the department.
(5) Coordinate services authorized by this article within and
between county service providers.
(6) Provide technical assistance to service providers.
(7) Review, and suggest improvements to proposed county school
district antitobacco plans. Prepare a letter for the county officer
of education setting forth conclusions of the review. Work closely
with the county office of education to ensure effective coordination
of local school and nonschool antitobacco efforts.
(8) Coordinate activities with other governmental agencies.
(c) The local plans described in paragraph (4) of subdivision (b)
shall include all of the following:
(1) A description of the targeted population, including age, race,
ethnicity, language, education, income levels, its status as urban
or rural, transportation needs, and any other information which the
local lead agency determines is relevant.
(2) Local data on smoking and tobacco use among the targeted
population.
(3) Goals for how many persons of the targeted population will be
reached by health education, how many will participate in a smoking
prevention or cessation program, and how many will quit or not start
smoking as a result.
(4) A description of the direct services to be provided under the
plan, including the services to be provided to the targeted
populations enumerated in Section 104360 and schoolage youth who do
not receive services through public school programs.
(5) Cost estimates for programs identified in the plan.
104405. Local lead agencies shall obtain the involvement and
participation of local community organizations with special
experience and expertise in community health education against
tobacco usage, including representatives of high-risk populations.
Local lead agencies shall include in their plan submitted pursuant to
Section 104400 a description of how they shall fulfill this
requirement. Representatives of these local groups shall assist and
advise the local lead agency in all aspects of the local plan
implemented pursuant to this article.
104410. The following goals and priorities shall govern funding
services provided under this article pursuant to local plans:
(a) The provisions of preventive health education against tobacco
use aimed at targeted populations, including pregnant women, mothers
of young children, and minorities, school dropouts, and other
school-aged youth who would otherwise be unserved.
(b) The provisions of preventive health education against tobacco
use aimed at school-age youth and their families in the community.
(c) The provision of preventive health education against tobacco
use aimed at the workplace and the community.
104415. (a) Local lead agencies shall attempt to ensure that
preventive education against tobacco use for targeted populations is
provided in a way that reaches all geographic areas of the county.
(b) In choosing among eligible service providers available to
serve the targeted populations described in subdivision (a), the
local lead agency shall give priority to programs presently providing
preventive health education, case management services to the
targeted populations which are compatible with preventive health
education against tobacco use, or other services in which preventive
health education against tobacco use can be incorporated in a logical
and efficient manner.
104420. The State Department of Education shall provide the
leadership for the successful implementation of this article in
programs administered by local public and private schools, school
districts, and county offices of education. The State Department of
Education shall do all of the following:
(a) Provide a planning and technical assistance program to carry
out its responsibilities under this article.
(b) Provide guidelines for schools, school districts, and school
district consortia to follow in the preparation of plans for
implementation of antitobacco use programs for schoolage populations.
The guidelines shall:
(1) Require the applicant agency to select one or more model
program designs and shall permit the applicant to modify the model
program designs to take special local needs and conditions into
account.
(2) Require the applicant agency to prepare for each target
population to be served a description of the service to be provided,
an estimate of the number to be served, an estimate of the success
rate and a method to determine to what extent goals have been
achieved.
(3) Require plan submissions to include a staffing configuration
and a budget setting forth use and distribution of funds in a clear
and detailed manner.
(c) Prepare model program designs and information for schools,
school districts, consortia, and county offices of education to
follow in establishing direct service programs to targeted
populations. Model program designs shall, to the extent feasible, be
based on studies and evaluations that determine which service
delivery systems are effective in reducing tobacco use and are cost
effective. The State Department of Education shall consult with the
department, and school districts with existing antitobacco programs
in the preparation of model program designs and information.
(d) Provide technical assistance for schools, school districts,
and county offices of education regarding the prevention and
cessation of tobacco use. In fulfilling its technical assistance
responsibilities, the State Department of Education may establish a
center for tobacco use prevention that shall identify, maintain, and
develop instructional materials and curricula encouraging the
prevention or cessation of tobacco use. The State Department of
Education shall consult with the department and others with expertise
in antitobacco materials or curricula in the preparation of these
materials and curricula.
(e) Monitor the implementation of programs that it has approved
under this article to ensure successful implementation.
(f) Prepare guidelines within 180 days of the effective date of
this article for a school-based program of outreach, education,
intervention, counseling, peer counseling, and other activities to
reduce and prevent smoking among schoolage youth.
(g) Assist county offices of education to employ a tobacco use
prevention coordinator to assist local schools and local public and
community agencies in preventing tobacco use by pupils.
(h) Train the tobacco use prevention coordinators of county
offices of education so that they are:
(1) Familiar with relevant research regarding the effectiveness of
various kinds of antitobacco use programs.
(2) Familiar with department guidelines and requirements for
submission, review, and approval of school-based plans.
(3) Able to provide effective technical assistance to schools and
school districts.
(i) Establish a tobacco-free school recognition awards program.
(j) As a condition of receiving funds pursuant to this article,
the State Department of Education, county offices of education, and
school districts shall ensure that they coordinate their efforts
toward smoking prevention and cessation with the lead local agency in
the community where the local school district is located.
(k) (1) Develop, in coordination with the county offices of
education, and administer a competitive grant program for
school-based, antitobacco education programs and tobacco use
intervention and cessation activities in order to reduce the number
of pupils who begin to use tobacco, continue to use tobacco, or both.
Grants shall be awarded, after consultation with local lead
agencies, the committee, and representatives of nonprofit
organizations dedicated to the reduction of tobacco-associated
disease, to school districts and county offices of education for all
pupils in grades 6 to 12, inclusive, that comply with the
requirements of paragraphs (2) and, if applicable, (3).
(2) Every school district and county office of education that
receives a grant pursuant to this section shall provide tobacco-use
prevention instruction that addresses all of the following essential
topics:
(A) Immediate and long-term undesirable physiologic, cosmetic, and
social consequences of tobacco use.
(B) Reasons that adolescents say they smoke or use tobacco.
(C) Peer norms and social influences that promote tobacco use.
(D) Refusal skills for resisting social influences that promote
tobacco use.
(3) Every school district and county office of education that
receives a grant pursuant to this section for pupils in grades 7 to
12, inclusive, shall provide tobacco-use intervention and cessation
activities targeted for pupils in high risk groups.
(4) The State Department of Education shall develop criteria and
standards for the allocation of grant awards that consider the need
to balance rural, suburban, and urban projects. In addition, the
State Department of Education shall give priority to applicants and
programs that do all of the following:
(A) Target current smokers and pupils most at risk for beginning
to use tobacco.
(B) Offer or refer pupils to cessation classes for current
smokers.
(C) Utilize existing antismoking resources, including local
antismoking efforts by local lead agencies and competitive grant
recipients.
(D) Design the project to coordinate with other community
services, including, but not limited to, local health agencies,
voluntary health organizations, and parent organizations.
(E) Design the project to use and develop existing services and
resources.
(F) Demonstrate an understanding of the role that the environment
and community norms play in influencing tobacco use.
(5) Available funds shall determine grant award amounts.
(l) Allocate funds to county offices of education to provide
technical assistance and leadership for tobacco use prevention,
intervention, and cessation programs. The funds shall be allocated to
all participating county offices of education at a minimum amount of
thirty-seven thousand five hundred dollars ($37,500). If funds
appropriated for purposes of allocating at least thirty-seven
thousand five hundred dollars ($37,500) to all participating county
offices of education are insufficient, the Superintendent of Public
Instruction shall prorate available funds among participating county
offices of education ensuring that all participating county offices
of education receive an equal minimum level of funding of
thirty-seven thousand five hundred dollars ($37,500). If funds are
sufficient to provide all participating county offices of education a
minimum of thirty-seven thousand five hundred dollars ($37,500), the
remaining funds shall be allocated according to the following
schedule based on average daily attendance in the prior year credited
to all elementary, high, and unified school districts, and to the
county superintendent of schools within the county as certified by
the Superintendent of Public Instruction:
(1) For counties with over 550,000 units of average daily
attendance, thirty cents ($0.30) per average daily attendance.
(2) For counties with more than 100,000 and less than 550,000
units of average daily attendance, sixty-five cents ($0.65) per
average daily attendance.
(3) For counties with more than 50,000 and less than 100,000 units
of average daily attendance, ninety cents ($0.90) per average daily
attendance.
(4) For counties with more than 37,500 and less than 50,000 units
of average daily attendance, one dollar ($1) per average daily
attendance.
(5) For counties with less than 37,500 units of average daily
attendance, thirty-seven thousand five hundred dollars ($37,500).
(m) Allocate funds appropriated by the act adding this subdivision
for local assistance to school districts and county offices of
education based on average daily attendance reported in the second
principal apportionment in the prior fiscal year.
(n) (1) Provide that all school districts and county offices of
education that receive funding under subdivision (m) make reasonable
progress toward providing a tobacco-free environment in school
facilities for pupils and employees.
(2) All school districts and county offices of education that
receive funding pursuant to paragraph (1) shall adopt and enforce a
tobacco-free campus policy no later than July of each fiscal year.
The policy shall prohibit the use of tobacco products, any time, in
district-owned or leased buildings, on district property and in
district vehicles. Information about the policy and enforcement
procedures shall be communicated clearly to school personnel,
parents, pupils, and the larger community. Signs stating "Tobacco use
is prohibited" shall be prominently displayed at all entrances to
school property. Information about smoking cessation support programs
shall be made available and encouraged for pupils and staff. Any
school district or county office of education that does not have a
tobacco-free district policy implemented by July 1, shall not be
eligible to apply for funds from the Cigarette and Tobacco Products
Surtax Fund for that fiscal year.
104430. (a) The State Department of Education shall make available
funds appropriated to it from the Health Education Account in the
Cigarette and Tobacco Products Surtax Fund for the implementation of
Section 104420 according to the following schedule:
(1) (A) Not less than two-thirds of that amount shall be awarded
to local educational agencies. Funds allocated pursuant to paragraphs
(2) and (3) shall not be considered funds for distribution to local
educational agencies.
(B) Not less than two hundred thousand dollars ($200,000) of the
amount subject to subparagraph (A) shall be made available for
proportionate awards to applicant education centers pursuant to
Article 6 (commencing with Section 33380) of Chapter 3 of Part 20 of
the Education Code, for tobacco use prevention projects.
(2) Not less than two hundred thousand dollars ($200,000) of the
amount awarded pursuant to Section 104420 shall be used for the
support of statewide program evaluation.
(3) Not more than nine hundred thousand dollars ($900,000) of the
amount awarded pursuant to Section 104420 shall be awarded as grants
for technical assistance, implementation strategies, and regional
coordinating activities related to tobacco use prevention pursuant to
subdivision (l) of Section 104420.
(b) Any amount that exceeds the amounts specified in subdivision
(a) shall be allocated for competitive grants pursuant to subdivision
(l) of Section 104420.
(c) On and after January 1, 1992, funding to which this section
applies shall be made available only upon a determination by the
Legislative Analyst and the Tobacco Education Oversight Committee, in
the evaluation required by subdivision (c) of Section 104375,
indicating that the tobacco use prevention program meets the purpose
of this article.
104435. County offices of education that receive funds pursuant to
subdivision (l) of Section 104420 shall do all of the following:
(a) Provide technical assistance and training to school districts
and consortia of school districts regarding planning and preparation
of antitobacco programs plans pursuant to State Department of
Education guidelines.
(b) Provide for appropriate coordination between school districts
programs and local antitobacco use programs funded by the local lead
agency.
(c) Participate in the review and scoring of applications
submitted by school districts for grant awards made pursuant to
Section 104420.
(d) Participate in the monitoring and technical assistance review
process for school districts and county offices of education pursuant
to Section 104455.
104440. Local lead agencies shall be ineligible for awards under
the competitive grants program, unless the local lead agency is
participant within a consortium of community-based organizations or
nonprofit organizations.
104445. In awarding grants under the competitive grants program,
the department shall give preference to all of the following:
(a) Nonprofit or community-based organizations.
(b) Current contractors that meet both of the following
requirements:
(1) Have demonstrated effectiveness and capacity in providing
tobacco education services.
(2) Serve populations and areas with substantial unmet service
needs.
(c) Proposals that provide new or expanded services to geographic
areas or target populations underserved, as determined by the
department.
104450. (a) The State Department of Education shall develop a
common reporting format for districts receiving
tobacco-use-prevention funds under this article.
(b) The format required by subdivision (a) shall be designed to
provide annual data on all of the following:
(1) Tobacco-use-prevention education program expenditures.
(2) Tobacco-use-prevention education program instructional and
other services to targeted and general student populations.
(3) Tobacco-use-prevention education program staff development and
parent training.
(4) Other information determined to be appropriate by the
department.
(c) The information provided by the format required by subdivision
(a) shall be in a quantitative format that describes the number of
individuals who are served and the number of individuals receiving
each type of service.
(d) In addition to the requirements of subdivision (c), the
information to be provided by the format required by subdivision (a)
shall include, at a minimum, all of the following:
(1) (A) The number of students receiving tobacco-use-prevention
instruction and the type of curriculum used.
(B) The format required by subdivision (a) shall show, by
category, those students listed for the purpose of subparagraph (A),
in each target group listed in Section 104360.
(2) Other programmatic activities directly targeted to students,
and the number of students participating in each.
(3) The types of staff development or other tobacco-use-prevention
training and, by staff classification, the number of staff members
receiving the training.
(4) The number of parents receiving training and the types of
training provided.
(5) The types of programs geared toward community involvement and
the number of people served by each type.
(6) The types of services provided to target populations that are
in addition to services provided to other students.
(7) The number and size of schools that are tobacco-free.
(8) The ways in which money appropriated for the purpose of this
article has been spent, including the following categories: salaries,
including, but limited to, personnel, and substitute teacher costs;
benefits; travel; consultant services; operating expenses, including,
but not limited to, curriculum and instructional materials,
supplies, other; capital outlay; and indirect costs.
(e) (1) Each county office of education shall provide to the State
Department of Education an annual report on district expenditures
and services within its respective county pursuant to the common
reporting format developed by the State Department of Education.
(2) The county shall provide an annual report of the information
required in paragraph (8) of subdivision (d).
104455. The State Department of Education shall monitor and ensure
implementation of district and county offices of education
tobacco-free policies and tobacco-use prevention education programs
in districts receiving funding from the Cigarette and Tobacco
Products Surtax Fund through procedures determined by the
Superintendent of Public Instruction after consultations with the
committee.
104460. (a) Each school district receiving funds from the Cigarette
and Tobacco Products Surtax Fund shall make all of the following
services available to every pregnant minor and minor parent enrolled
in the school district:
(1) Referral to perinatal and related support services.
(2) Outreach services and assessment of smoking status.
(3) Individualized counseling and advocacy services.
(4) Motivational messages.
(5) Cessation services, if appropriate.
(6) Incentives to maintain a healthy lifestyle.
(7) Followup assessment.
(8) Maintenance and relapse prevention services.
(b) Where appropriate, those services listed in subdivision (a)
shall be integrated with existing programs for pregnant minors and
minor parents.
(c) Each district plan submitted in application for funds under
this article shall include a description of the availability of the
services required by this section.
104465. (a) The department may annually set aside three million
dollars ($3,000,000) appropriated for the purposes of the competitive
grants program established pursuant to this article in order to
support efforts to link the statewide media campaign to local
communities and to provide regional public and community relations or
media initiatives.
(b) Local community initiatives may include, but are not limited
to, all of the following:
(1) Encouraging volunteer efforts.
(2) Local media programming.
(3) Provision of assistance in, and facilitation of, public and
community events.
(c) The efforts described in subdivision (b) shall be directed
principally to the target communities described in Section 104360.
(d) Regular application procedures for competitive grants under
this article shall apply to applications for grants under this
section.
(e) Funds awarded pursuant to this section shall be awarded in the
same manner as other competitive grants under this article.
104466. Notwithstanding subdivision (a) of Section 2.00 of the
Budget Act of 2002 and any other provision of law, commencing with
the appropriation for the 2002-03 fiscal year, and for each fiscal
year thereafter, any amount appropriated to the department to
implement the following tobacco use prevention programs shall be
available for encumbrance and expenditure for three fiscal years
beyond the date of the appropriation:
(a) The program to evaluate tobacco control programs provided for
in subdivisions (b) and (c) of Section 104375.
(b) The tobacco use prevention media campaign provided for in
subdivision (e) of Section 104375.
(c) The competitive grant program provided for in Section 104385.
(d) The local lead agency tobacco use prevention programs provided
for in Section 104400.
(e) The tobacco use prevention program directed at schools
provided for in Sections 104420, 104425, 104430, and 104435.
104470. The State Department of Education shall make periodic
reports to the committee regarding the status and funding of tobacco
education programs funded under this article as required by the
committee. The reports shall include an overview of program and grant
expenditures funded under this article.
104475. There is hereby created under the authority of the
Controller the Tobacco Education Fund.
104480. All guidelines, criteria, standards, and requirements
specified in this article are exempt from the requirements of Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, and shall be implemented without being
adopted as regulations.
104495. (a) For the purposes of this section, the following
definitions shall govern:
(1) "Playground" means any park or recreational area specifically
designed to be used by children that has play equipment installed, or
any similar facility located on public or private school grounds, or
on city, county, or state park grounds.
(2) "Tot lot sandbox area" means a designated play area within a
public park for the use by children under five years of age. Where
the area is not contained by a fence, the boundary of a tot lot
sandbox area shall be defined by the edge of the resilient surface of
safety material, such as concrete or wood, or any other material
surrounding the tot lot sandbox area.
(3) "Public park" includes a park operated by a public agency.
(4) "Smoke or smoking" means the carrying of a lighted pipe,
lighted cigar, or lighted cigarette of any kind, or the lighting of a
pipe, cigar, or cigarette of any kind, including, but not limited
to, tobacco, or any other weed or plant.
(5) "Cigarette" means the same as defined in Section 104556.
(6) "Cigar" means the same as defined in Section 104550.
(b) No person shall smoke a cigarette, cigar, or other
tobacco-related product within 25 feet of any playground or tot lot
sandbox area.
(c) No person shall dispose of cigarette butts, cigar butts, or
any other tobacco-related waste within 25 feet of a playground or a
tot lot sandbox area.
(d) No person shall intimidate, threaten any reprisal, or effect
any reprisal, for the purpose of retaliating against another person
who seeks to attain compliance with this section.
(e) Any person who violates this section is guilty of an
infraction and shall be punished by a fine of two hundred fifty
dollars ($250) for each violation of this section. Punishment under
this section shall not preclude punishment pursuant to Section 13002,
Section 374.4 of the Penal Code, or any other provision of law
proscribing the act of littering.
(f) The prohibitions contained in subdivisions (b), (c), and (d)
shall not apply to private property.
(g) The prohibitions contained in subdivisions (b) and (c) shall
not apply to a public sidewalk located within 25 feet of a playground
or a tot lot sandbox area.
(h) This section shall not preempt the authority of any county,
city, or city and county to regulate smoking around playgrounds or
tot lot sandbox areas. Any county, city, or city and county may
enforce any ordinance adopted prior to January 1, 2002, or may adopt
and enforce new regulations that are more restrictive than this
section, on and after January 1, 2002.
104350. (a) The Legislature finds and declares as follows:
(1) Smoking is the single most important source of preventable
disease and premature death in California.
(2) More than 30 percent of coronary heart disease cases are
attributable to cigarette smoking.
(3) More than 30 percent of all annual cancer deaths are
attributable to smoking, with lung cancer now the leading cancer
killer in women as well as men.
(4) Smoking is responsible for one-quarter of all deaths caused by
fire.
(5) Involuntary smoking is a cause of disease, including lung
cancer, in healthy nonsmokers.
(6) More than 80 percent of chronic obstructive lung diseases
including emphysema and chronic bronchitis are attributable to
smoking.
(7) Tobacco-related disease places a tremendous financial burden
upon the persons with the disease, their families, the health care
delivery system, and society as a whole. California spends five
billion six hundred million dollars ($5,600,000,000) a year in direct
and indirect costs on smoking-related illnesses.
(8) The elimination of smoking is the number one weapon against
four of the five leading causes of death in California.
(9) Keeping children and young adults from beginning to use
tobacco and encouraging all persons to quit tobacco use shall be the
highest priority in disease prevention for the State of California.
More than 60 percent of all smokers begin smoking by the age of 14,
and 90 percent begin by the age of 19.
(10) The State of California shall play a leading role in
promoting a smoke-free society by the year 2000 and thereby
supporting the National Health Status Objectives for the year 2000
relating to smoking and tobacco use.
(b) It is the intent of the Legislature, therefore, to require the
department, local lead agencies, and the State Department of
Education to cooperatively and individually conduct activities
directed at the prevention of tobacco use and tobacco-related
diseases. The campaign shall focus on health promotion, disease
prevention, and risk reduction, utilizing a "wellness" perspective
that encourages self-esteem and positive decisionmaking techniques.
It is also the intent of the Legislature that, for the purpose of
program planning and program evaluation, the department provide data
and technical information on tobacco-related diseases, tobacco use
and its consequences, and effective personal and community
interventions to prevent tobacco use.
104355. The following definitions shall apply to this article:
(a) "Grantee" means any public or private nonprofit entity
approved by the department or the State Department of Education to
receive funds pursuant to this article. Grantees may include, but are
not limited to, hospitals, community clinics, local health
departments, voluntary health organizations, Indian tribes, colleges
and universities, county offices of education, school districts,
health maintenance organizations, professional health associations,
and professional health education associations.
(b) "Tobacco-related disease" means any of the following:
(1) Coronary heart disease.
(2) Cerebrovascular disease.
(3) Cancer, including cancers of the lung, larynx, esophagus,
bladder, pancreas, and mouth.
(4) Chronic obstructive lung diseases, including emphysema,
chronic bronchitis, asthma, and related lung disorders.
(5) Conditions where smoking or tobacco use has been determined to
be a risk factor for excess disability and illness, including burns
due to smoking-related fires.
(c) "Tobacco use" means the consumption of tobacco products by
burning, chewing, inhalation, or other forms of ingestion.
(d) "Voluntary health organization" means a nonprofit organization
organized for purposes related to health, including, but not limited
to, an organization devoted to the research of cancer, heart
disease, or diseases of the lung.
(e) "Committee" means the Tobacco Education Oversight Committee.
(f) "The department" means the State Department of Health
Services.
(g) "Service provider" means an agency or organization that enters
into an agreement with the local lead agency or state department to
provide services under this article.
(h) "Direct services" means the provision of preventive health
education services to targeted populations.
(i) "Local plan" means a plan submitted pursuant to Section
104400.
(j) "Preventive health education against tobacco use" means
programs of instruction intended to dissuade individuals from
beginning to smoke, to encourage smoking cessation, or to provide
information on the health effects of tobacco on the user, children,
and nonsmokers. These programs may include a focus on health
promotion, disease prevention, and risk reduction, utilizing a
"wellness perspective" that encourages self-esteem and positive
decisionmaking techniques.
(k) "Targeted populations" means those population groups specified
in Sections 104360 and 104385.
( l) "Local lead agencies" means those agencies designated as
local lead agencies pursuant to Section 104400.
104360. The following target populations, at a minimum, shall be
the focus of the campaign implemented pursuant to this article:
(a) School-age youth and their families in the schools and in the
community.
(b) Black, Hispanic, Native American, and Asian-Pacific American
populations, pregnant women, and current smokers.
104365. (a) There is hereby created the Tobacco Education and
Research Oversight Committee in state government that shall advise
the department and the State Department of Education with respect to
policy development, integration, and evaluation of tobacco education
programs funded under this article, and for development of a master
plan for the future implementation of tobacco education programs.
(b) The Tobacco Education Oversight Committee shall be composed of
13 members to be appointed as follows:
(1) Two members representing volunteer health organizations
dedicated to the reduction of tobacco use appointed by the Speaker of
the Assembly.
(2) One member representing an organization that represents health
care employees appointed by the Senate Rules Committee.
(3) One member of a professional education association, such as an
association of teachers, appointed by the Senate Rules Committee.
(4) One member of a university facility with expertise in programs
intended to reduce tobacco use appointed by the Governor.
(5) Two representatives of a target population group appointed by
the Governor.
(6) One representative of the department appointed by the
Governor.
(7) One representative of the State Department of Education
appointed by the Superintendent of Public Instruction.
(8) One member representing the interests of the general public
appointed by the Governor.
(9) One representative of local health departments appointed by
the Governor.
(10) One member representing a volunteer health organization
dedicated to the reduction of tobacco associated injury appointed by
the Governor.
(11) One member from the Tobacco Related Disease Research Program
appointed by the Governor.
(c) Members shall serve for a term of two years, renewable at the
option of the appointing authority. The initial appointments of
members shall be for two or three years, to be drawn by random lot at
the first meeting. The committee shall be staffed by the department'
s coordinator of the program created pursuant to Section 104375.
(d) The committee shall meet as often as it deems necessary, but
shall meet not less than four times per year.
(e) The members of the committee shall serve without compensation,
but shall be reimbursed for necessary travel expenses incurred in
the performance of the duties of the committee.
104370. The committee shall be advisory to the department, the
University of California, and State Department of Education for the
following purposes:
(a) Evaluation of research, school- and community-based programs
funded under this article as necessary in order to assess the overall
effectiveness of efforts made by the programs to reduce the use of
tobacco products. In order to evaluate tobacco education, research,
and cessation programs, the committee shall seek the cooperation and
assistance of the department, the State Department of Education,
county offices of education, local lead agencies, administrative
representatives, target populations, school officials, and
researchers. A principal measurement of effectiveness shall be
reduction of smoking rates among a given target population.
(b) Facilitation of programs directed at reducing and eliminating
tobacco use that are operated jointly by more than one agency or
entity. The committee shall propose strategies for the coordination
of proposed programs administered by the department, the University
of California, and the State Department of Education in order to
avoid the duplication of services and to maximize the public benefit
of the programs.
(c) Make recommendations to the department, the University of
California, and the State Department of Education regarding the most
appropriate criteria for the selection of, standards of the operation
of, and the types of programs to be funded under this article.
(d) Reporting to the Legislature on or before January 1 of each
year on the number and amount of tobacco education programs funded by
the Health Education Account, created by Section 30122 of the
Revenue and Taxation Code, the amount of money in the account, any
moneys previously appropriated to the department, the University of
California, and the State Department of Education but unspent by the
departments, a description and assessment of all programs funded
under this article, and recommendations for any necessary policy
changes or improvements for tobacco education programs.
(e) Ensuring that the most current research findings regarding
tobacco use prevention are applied in designing the tobacco education
programs administered by the department and the State Department of
Education. The department and the State Department of Education shall
apply the most current findings and recommendations of research
including research funded by the Research Account of the Cigarette
and Tobacco Products Surtax Fund created by Section 30122 of the
Revenue and Taxation Code.
(f) Based on the results of programs supported by this article and
any other proven methodologies available to the committee, produce a
comprehensive master plan for implementing tobacco education
programs throughout this state for the prevention and cessation of
tobacco use. The master plan shall include implementation strategies
for each target population specified in Section 104360 for programs
throughout this state. The Tobacco Education and Research Oversight
Committee shall submit the master plan to the Legislature biennially.
The master plan and its revisions shall include recommendations on
administrative arrangements, funding priorities, integration and
coordination of approaches by the department, the University of
California, and the State Department of Education and their support
systems, as well as progress reports relating to each target
population. The master plan shall establish a goal of achieving a
75-percent reduction in tobacco consumption in California by the year
1999.
104375. (a) To prevent tobacco-related diseases and diminish
tobacco use, the department shall establish within the department a
program on tobacco use and health to reduce tobacco use in California
by conducting health education interventions and behavior change
programs at the state level, in the community, and other nonschool
settings.
(b) The department shall conduct statewide surveillance of
tobacco-related behaviors, knowledge, and attitudes and evaluate the
department's local and state tobacco control programs under this
article. At a minimum, these evaluation activities shall utilize
scientifically appropriate methods for monitoring the annual progress
of the program in reducing the adult smoking prevalence from the
1993 benchmark rate of 20 percent and reducing cigarette consumption
from the 1993 per capita benchmark rate of 4.84 packs per quarter.
These surveillance and evaluation activities may include, but need
not be limited to, the following:
(1) Be based on sound evaluation principles and include, to the
extent feasible, elements of controlled experimental methods.
(2) Monitor the overall statewide effect of health education
efforts on smoking and tobacco use, and, to the extent feasible, the
resulting effects on health.
(3) Monitor the effect of the programs on individual target
populations identified by this article or designated by the
department as meriting special attention.
(4) Provide an evaluation of the comparative effectiveness of
individual program designs that shall be used in funding decisions
and program modifications.
(5) Incorporate other aspects into the evaluation that have been
identified by the department in consultation with state and local
advisory groups, local lead agencies, and other interested parties.
(6) Funds permitting, utilize a sample size that is adequate to
produce county, regional, and ethnic specific estimates.
(c) The department shall produce or contract for, and update
biennially, a description of programs determined to be effective in
reducing smoking and tobacco use, and the identification of portions
of target populations that need information regarding the hazards of
tobacco use. The department, in consultation with the State
Department of Education, shall conduct, or contract for an evaluation
of the effectiveness of the tobacco use prevention and education
program as implemented in the public schools that receive funding for
tobacco use prevention education pursuant to Sections 104420,
104425, 104435, and 104445. The purpose of the evaluation shall be to
direct the most efficient allocation of resources appropriated under
this article to accomplish the maximum prevention and reduction of
tobacco use. The comprehensive evaluation shall be designed to
measure the extent to which programs funded pursuant to this article
promote the goals identified in this article and in Proposition 99 of
the November 1988 general election. All information resulting from
the evaluation shall be made available to the State Department of
Education for purposes of improving its ability to implement and
oversee the provision of effective tobacco use prevention education
programs. The evaluator shall:
(1) Assess the effectiveness of tobacco use prevention education
programs designed to prevent and reduce tobacco use among students.
In support of this primary goal, the evaluation shall:
(A) Report findings on the effectiveness of programs and
strategies currently in use in California schools that prevent and
reduce tobacco use.
(B) Select a research strategy that will identify formal and
informal factors that might account for differences in tobacco use by
students, including, but not limited to, formal education prevention
strategies.
(C) Incorporate in the evaluation quantitative as well as
qualitative data. The data shall include, but are not limited to:
(i) Student data, including attitudes, knowledge, and behavior
based upon a statistically valid random sample of school districts
and students.
(ii) Curriculum data, including diversity of curricula, evidence
of appropriateness to grade level, gender, and ethnicity, and the
extent of the inclusion of prevention approaches identified in
research literature.
(iii) School data, including intensity of emphasis on tobacco use
prevention and evidence of counseling or treatment referral systems.
(iv) Community data, including the existence of parent networks
and the participation of community service organizations including
local lead agencies, in prevention.
(2) Develop and test a regular tobacco use prevention and
education information system for use by the State Department of
Education, using the resulting information to establish the extent of
implementation of tobacco use prevention education programs
statewide and the degree of student exposure to these programs at
selected grade levels.
(3) Ensure provision of a fourth administration of a statewide,
biennial survey of attitudes toward tobacco and prevalence of tobacco
use among public school students. To the extent possible, existing
survey data shall be utilized.
(4) Provide recommendations to the Legislature and the State
Department of Education on tobacco use prevention education program
changes.
(5) Assist the State Department of Education in identifying and
developing instructional materials and curricula in school-based
programs, designed to enhance the prevention of and encouraging the
cessation of the continuing use of, tobacco products. The materials
and curricula shall address the specific needs of persons in grades 4
to 12, inclusive, and in adult education programs.
(d) School districts shall agree, as a condition of receiving
money pursuant to this article, to participate in the evaluation if
chosen by the evaluator.
(e) (1) The department shall contract with one or more qualified
agencies for production and implementation of an ongoing public
awareness of tobacco-related diseases by developing an information
campaign using a variety of media approaches. The department shall
issue a request for proposals biennially. Any media campaign funded
with this part shall stress the importance of both preventing the
initiation of tobacco use and quitting smoking and shall be based on
professional market research and surveys necessary to determine the
most effective method of diminishing tobacco use among specified
target populations. Initial media efforts shall be directed to
specific target populations. The contractors selected shall be
provided with all available survey information resulting from ongoing
programs funded under this article. Priority shall be given to minor
children, ages 6 to 14, inclusive. The medium used shall be
determined to be the most effective at reaching this targeted age
group. With respect to the broadcast media, the message shall be
aired at times expected to reach the priority age group. With respect
to the print media, publications to be used shall be those that
appeal to the priority age group.
(2) No media campaign funded pursuant to this article shall
feature in any manner the image or voice of any elected public
official or candidate for elected office, or directly represent the
views of any elected public official or candidate for elected office.
(f) The department shall provide or contract for training,
consultation, support, and continuing education to health
professionals, and others interested in developing programs and
services directed at preventing tobacco use and promoting smoking
cessation, utilizing, when available and determined appropriate by
the department, the expertise of universities in this state and
schools of public health. The training, consultation, support, and
continuing education shall include advice and support in creating a
smoke-free environment.
(g) The department shall conduct an awards program to acknowledge
the outstanding achievements of those communities, organizations, and
groups that have fostered movement toward a smoke-free society or
have reduced the consumption of tobacco.
(h) The department shall issue guidelines for local plans for
education against tobacco use. The guidelines shall require local
public health departments to provide services directed at preventing
tobacco use and promoting smoking cessation to the target populations
enumerated in Section 104360 and to persons under 19 years of age
who no longer attend school and to youth attending school who are not
served through State Department of Education funded programs. The
guidelines shall require for each target population to be served a
description of the services to be provided, an estimate of the number
to be served, an estimate of the success rate, and a method to
determine to what extent goals have been achieved. Beginning with the
1990-91 fiscal year, and for each fiscal year thereafter, the
guidelines shall require local lead agencies to describe how local
funding decisions will take into account evaluations of program
effectiveness and efficiency. The guidelines shall require the
submission of a budget and information on staffing configurations.
(i) By December 31, 1989, the department shall issue guidelines
for fiscal year 1989-90 and by July 1, 1990, the department shall
issue guidelines to local lead agencies on how to prepare a local
plan for a comprehensive community intervention program against
tobacco use.
(j) The department shall provide technical assistance to local
lead agencies for the development of plans required by Section 104400
so that the local lead agencies are able to comply with the schedule
for the submission of plans specified in Section 104400. The
technical assistance shall include, but not be limited to, the
following:
(1) Developing and disseminating preventive health education
program options for local communities.
(2) Providing training, consultation, and technical assistance to
local health departments, local advisory committees, and service
providers.
(k) The department shall receive and approve local plans submitted
by local lead agencies and provide technical assistance and guidance
as necessary to ensure the compliance of the local lead agencies
with this article. Every effort shall be made to approve or provide a
list of necessary amendments to a local plan within 30 days of
receipt of the local plan. The department may authorize a local lead
agency to begin implementation of its local plan on a provisional
basis, with final approval of the local plan contingent on satisfying
conditions specified by the department.
( l) The department shall work in collaboration with the public
and private sectors in implementing the activities required of the
department and provide access upon request to local plans, program
statistics, and other readily available information.
(m) The department shall provide staff, assistance, and support
needed by the committee.
(n) In consultation with the committee, the department shall
develop a comprehensive master plan for implementing tobacco
education programs throughout the state for the prevention and
cessation of tobacco use.
(o) The department shall consult regularly with the University of
California regarding trends in the frequency and the cost of treating
tobacco-related diseases and the success of research efforts to
reduce tobacco use and limit its adverse health effects.
(p) The department shall establish, in consultation with the State
Department of Education and county offices of education, a data
collection and data management program to study effective tobacco use
interventions. Under this program the department may contract for
studies and evaluations in school-based and community-based programs.
The department shall consult with the State Department of Education
regarding the collection and evaluation of program data.
(1) The department shall require, by contract, that local lead
agencies use a uniform management data and information system that
will permit comparisons of workload, unit costs, and outcome
measurements on a statewide basis. The department shall specify data
reporting requirements for local lead agencies and their
subcontractors.
(2) The department shall approve local lead agency and grantee
computer software and hardware in order to ensure systemwide
compatibility and capacity to expand. Departmental guidelines for
local plans shall require local lead agencies to set forth their
hardware and software plans and needs.
(3) The department may contract for the development or operation
of a computerized management information system.
(4) The department shall consult the State Department of Education
regarding computer software and hardware systems for school-based
programs.
104380. (a) Funds appropriated to the department for local lead
agencies for purposes of this article shall be allocated
prospectively, on a quarterly basis in accordance with this section.
(b) No local lead agency shall be allocated less than one hundred
fifty thousand dollars ($150,000).
(c) (1) Except as provided in subdivision (b), counties not listed
in subdivision (d) shall receive an allocation based on each county'
s proportion of the statewide population.
(2) Counties that receive their allocations pursuant to paragraph
(1) shall receive 73 percent of their 1990-91 fiscal year allocation.
(d) Except as provided in subdivision (b), the balance of the
funds after the allocation contained in subdivision (c) have been
made, shall be allocated to the following specified counties in
accordance with the following percentages:
COUNTY ALLOCATION
Alameda 4.7427%
Contra Costa 1.8032%
Fresno 2.6855%
Kern 1.7083%
Lake 0.1826%
Los Angeles 43.8057%
Mendocino 0.2664%
Merced 0.7244%
Monterey 1.2937%
Orange 5.1382%
Placer 0.3697%
Riverside 3.1828%
Sacramento 3.2922%
San Bernardino 3.7972%
San Diego 5.9971%
San Francisco 5.3898%
San Joaquin 1.7413%
San Luis Obispo 0.8096%
San Mateo 1.4582%
Santa Barbara 0.7918%
Santa Clara 5.2450%
Santa Cruz 0.7709%
Stanislaus 1.2793%
Tulare 1.3768%
Ventura 1.5472%
Yolo 0.6004%
(e) Except as provided in subdivision (b), the allocation for
those counties in which a city health department which is a local
lead agency as defined by subdivision ( l) of Section 104355 is
located shall be apportioned among the local lead agencies in that
county based on their jurisdiction's proportionate share of the
countywide population.
(f) Reductions in allocations necessary to comply with subdivision
(b) shall be distributed among the counties listed in subdivision
(d) proportionately based on the table contained in subdivision (d).
(g) The department shall use population estimates for 1989 for
each county and for each city as specified in the Department of
Finance E-1 Report.
(h) Payments shall be made prospectively, on a quarterly basis, to
local jurisdictions.
(i) (1) The department shall conduct a fiscal and program review
on a regular basis.
(2) If the department determines that any county is not in
compliance with any provision of this chapter, the county shall
submit to the department, within 60 days, a plan for complying with
this article.
(3) The department may withhold funds from local lead agencies
allocated funds under this section that are not in compliance with
this chapter in the same manner as the department is authorized under
Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9
of the Welfare and Institutions Code. The department may terminate
the agreement with the noncompliant local lead agency, recoup any
unexpended funds from the noncompliant local lead agency, and
reallocate both the withheld and recouped funds to provide services
available under this section to the jurisdiction of the noncompliant
agency through an agreement with a different governmental or private
nonprofit agency capable of delivering those services based on the
department's local lead agency guidelines for local plans and a
process determined by the department. The department may encumber and
reallocate these funds no sooner than three months after the date of
the first notification that the department has determined the local
lead agency to be out of compliance with statutory requirements.
104385. (a) The department shall award and administer grants for
projects directed at the prevention of tobacco-related diseases. The
purpose of the grant program is to conduct health education and
promotion activities targeted to high-risk persons and groups in
order to reduce the number of persons beginning to use tobacco,
continuing to use tobacco, or developing tobacco-related diseases.
The grants shall provide funds to eligible grantees, as determined by
the department. In awarding grants, the department shall select a
variety of projects and grantees.
(b) The department shall develop criteria and standards for the
allocation of grant awards which consider the need to balance target
populations to be served, project types of rural suburban and urban
projects, and consider the current regional availability of similar
services. Target populations may include, but not be limited to,
children, young adults, pregnant women, low-income individuals,
Black, Hispanic, Native American, and Asian-Pacific Islander
populations, current smokers, and schoolaged youth no longer
attending school classes. The grant awards may also be made to school
districts for nonclassroom, districtwide efforts to reduce tobacco
use. The department shall develop mechanisms to evaluate all programs
and shall require any program funded under this article to provide
statistics on the impact of the program.
(c) The department shall give priority to grantees who do the
following:
(1) Demonstrate community support for the project.
(2) Design the project to coordinate with other community services
including local health programs, school-based programs, or voluntary
health organizations.
(3) Design the project to utilize and enhance existing services
and resources.
(4) Serve a target population at high risk of starting tobacco use
or developing tobacco-related illnesses.
(5) Demonstrate an understanding of the role community norms have
in influencing behavioral change regarding tobacco use.
(6) Indicate promising innovative approaches to diminishing
tobacco use among target groups and permit those approaches to be
replicated by others.
(d) Of the funds appropriated to the department in Item
4260-111-231 of the 1996 Budget Act, five million dollars
($5,000,000) shall be available specifically for grants awarded on a
competitive basis to provide smoking cessation classes or services
for persons eligible for and enrolled in the state's Medi-Cal
program, or persons who are medically indigent.
104390. (a) The department may provide program support services to
local tobacco use prevention programs, that shall include, but need
not be limited to, all of the following:
(1) Data collection.
(2) Educational materials.
(3) Evaluation.
(4) Technical assistance.
(5) Training.
(6) Transfer of information among programs.
(b) Services funded under this section may be awarded through a
competitive request for proposal process or directly to another state
agency, the Regents of the University of California, the federal
government, or an auxiliary organization of the California State
University.
(c) Grantees of services under this section shall demonstrate the
ability to do both of the following:
(1) Improve the delivery of local tobacco use prevention programs
directed at the targeted populations.
(2) Design programs to provide statewide and regional services to
support local implementation of tobacco use prevention programs.
104395. The department shall expand the Child Health and Disability
Prevention (CHDP) Program contained in Article 6 (commencing with
Section 124025) of Chapter 3 of Part 2 of Division 106 as follows:
(a) Any child between birth and 90 days after entrance into first
grade, all persons under 21 years of age who are eligible for the
California Medical Assistance Program, and any person under 19 years
of age whose family income is not more than 200 percent of the
federal poverty level shall be eligible for services under the
program in the county of which they are a resident. The department
shall adopt regulations specifying which age groups shall be given
certain types of screening tests and recommendations for referral.
(b) The first source of referral under the program shall be the
child's usual source of health care. If referral is required and no
regular source of health care can be identified, the facility or
provider providing health screening and evaluation services shall
provide a list of three qualified sources of care, without prejudice
for or against any specific source.
(c) The department shall issue protocols for an antitobacco
education component of the child health and disability prevention
medical examination. The protocols shall include the following:
dissuading children from beginning to smoke, encouraging smoking
cessation, and providing information on the health effects of tobacco
use on the user, children, and nonsmokers. The protocols shall also
include a focus on health promotion, disease prevention, and risk
reduction, utilizing a "wellness" perspective that encourages
self-esteem and positive decisionmaking techniques, and referral to
an appropriate community smoking cessation program.
(d) Notwithstanding any other provision of law, the department
shall ensure that a portion of the funds in the Child Health
Disability Prevention Program budget is used to facilitate the
integration of the medical and dental components of all aspects of
that program.
(e) The department shall expand its support and monitoring of
county child health and disability prevention program efforts to
provide all of the following:
(1) Review of a representative, statistically valid, randomly
selected sample of child health and disability prevention health
assessments, including, but not limited to, dental assessments, which
result in the discovery of conditions which require followup
diagnosis and treatment, including but not limited to dental
treatment, and which qualify for services under this section. The
purpose of the survey and followup reviews of local programs is to
determine whether necessary diagnosis and treatment services are
being provided, and the degree to which those services comply with
the intent of the act that added this subdivision. These survey
reviews shall include all counties and shall be conducted at least
three times a year.
(2) At least once a year, as part of regular visits to county
child health and disability prevention programs to provide technical
assistance, support services and monitoring and evaluation of program
performance, department staff shall review the effectiveness of the
mandated treatment program. The purpose of this review is to assure
that the county is providing appropriate followup services for
conditions discovered during child health and disability prevention
health assessments. This review shall be done in conjunction with the
ongoing survey activity of the Child Health and Disability
Prevention Branch of the department and shall utilize data resulting
from that activity.
(3) If the department establishes that a county has failed to
provide treatment services mandated by the act that added this
subdivision, the department shall require the county to submit a plan
of correction within 90 days. If the department finds that
substantial correction has not occurred within 90 days following
receipt of the correction plan, it may require the county to enter
into a contract pursuant to Section 16934.5 of the Welfare and
Institutions Code for the remainder of the fiscal year and the
following fiscal year, and for this purpose shall withhold the same
percentage of funds as are withheld from other counties participating
in the program pursuant to Section 16934.5 of the Welfare and
Institutions Code.
104400. (a) (1) Except as provided in paragraph (2), each county
health department or city health department as provided in Section
16800 of the Welfare and Institutions Code shall be the lead local
agency for its county. The local lead agency shall have the overall
responsibility for the success of the programs funded pursuant to
this article in its county.
(2) Counties contracting with the department for the provision of
health care services pursuant to Section 16809 of the Welfare and
Institutions Code may elect to enter into an arrangement with the
department for the administration and provision of funds and services
subject to this article in their counties. In those cases, the
department shall act as the local lead agency for that county.
(b) The local lead agency shall do all of the following:
(1) Provide, or contract for, preventive health education against
tobacco services to targeted populations.
(2) Establish a coordinated information, referral, outreach, and
intake system for preventive health education against tobacco
services for targeted populations.
(3) Administer funds in accordance with this article, and
department guidelines.
(4) Establish a uniform data collection system in compliance with
standards and guidelines issued by the department, and submit audit
and fiscal reports as required by the department.
(5) Coordinate services authorized by this article within and
between county service providers.
(6) Provide technical assistance to service providers.
(7) Review, and suggest improvements to proposed county school
district antitobacco plans. Prepare a letter for the county officer
of education setting forth conclusions of the review. Work closely
with the county office of education to ensure effective coordination
of local school and nonschool antitobacco efforts.
(8) Coordinate activities with other governmental agencies.
(c) The local plans described in paragraph (4) of subdivision (b)
shall include all of the following:
(1) A description of the targeted population, including age, race,
ethnicity, language, education, income levels, its status as urban
or rural, transportation needs, and any other information which the
local lead agency determines is relevant.
(2) Local data on smoking and tobacco use among the targeted
population.
(3) Goals for how many persons of the targeted population will be
reached by health education, how many will participate in a smoking
prevention or cessation program, and how many will quit or not start
smoking as a result.
(4) A description of the direct services to be provided under the
plan, including the services to be provided to the targeted
populations enumerated in Section 104360 and schoolage youth who do
not receive services through public school programs.
(5) Cost estimates for programs identified in the plan.
104405. Local lead agencies shall obtain the involvement and
participation of local community organizations with special
experience and expertise in community health education against
tobacco usage, including representatives of high-risk populations.
Local lead agencies shall include in their plan submitted pursuant to
Section 104400 a description of how they shall fulfill this
requirement. Representatives of these local groups shall assist and
advise the local lead agency in all aspects of the local plan
implemented pursuant to this article.
104410. The following goals and priorities shall govern funding
services provided under this article pursuant to local plans:
(a) The provisions of preventive health education against tobacco
use aimed at targeted populations, including pregnant women, mothers
of young children, and minorities, school dropouts, and other
school-aged youth who would otherwise be unserved.
(b) The provisions of preventive health education against tobacco
use aimed at school-age youth and their families in the community.
(c) The provision of preventive health education against tobacco
use aimed at the workplace and the community.
104415. (a) Local lead agencies shall attempt to ensure that
preventive education against tobacco use for targeted populations is
provided in a way that reaches all geographic areas of the county.
(b) In choosing among eligible service providers available to
serve the targeted populations described in subdivision (a), the
local lead agency shall give priority to programs presently providing
preventive health education, case management services to the
targeted populations which are compatible with preventive health
education against tobacco use, or other services in which preventive
health education against tobacco use can be incorporated in a logical
and efficient manner.
104420. The State Department of Education shall provide the
leadership for the successful implementation of this article in
programs administered by local public and private schools, school
districts, and county offices of education. The State Department of
Education shall do all of the following:
(a) Provide a planning and technical assistance program to carry
out its responsibilities under this article.
(b) Provide guidelines for schools, school districts, and school
district consortia to follow in the preparation of plans for
implementation of antitobacco use programs for schoolage populations.
The guidelines shall:
(1) Require the applicant agency to select one or more model
program designs and shall permit the applicant to modify the model
program designs to take special local needs and conditions into
account.
(2) Require the applicant agency to prepare for each target
population to be served a description of the service to be provided,
an estimate of the number to be served, an estimate of the success
rate and a method to determine to what extent goals have been
achieved.
(3) Require plan submissions to include a staffing configuration
and a budget setting forth use and distribution of funds in a clear
and detailed manner.
(c) Prepare model program designs and information for schools,
school districts, consortia, and county offices of education to
follow in establishing direct service programs to targeted
populations. Model program designs shall, to the extent feasible, be
based on studies and evaluations that determine which service
delivery systems are effective in reducing tobacco use and are cost
effective. The State Department of Education shall consult with the
department, and school districts with existing antitobacco programs
in the preparation of model program designs and information.
(d) Provide technical assistance for schools, school districts,
and county offices of education regarding the prevention and
cessation of tobacco use. In fulfilling its technical assistance
responsibilities, the State Department of Education may establish a
center for tobacco use prevention that shall identify, maintain, and
develop instructional materials and curricula encouraging the
prevention or cessation of tobacco use. The State Department of
Education shall consult with the department and others with expertise
in antitobacco materials or curricula in the preparation of these
materials and curricula.
(e) Monitor the implementation of programs that it has approved
under this article to ensure successful implementation.
(f) Prepare guidelines within 180 days of the effective date of
this article for a school-based program of outreach, education,
intervention, counseling, peer counseling, and other activities to
reduce and prevent smoking among schoolage youth.
(g) Assist county offices of education to employ a tobacco use
prevention coordinator to assist local schools and local public and
community agencies in preventing tobacco use by pupils.
(h) Train the tobacco use prevention coordinators of county
offices of education so that they are:
(1) Familiar with relevant research regarding the effectiveness of
various kinds of antitobacco use programs.
(2) Familiar with department guidelines and requirements for
submission, review, and approval of school-based plans.
(3) Able to provide effective technical assistance to schools and
school districts.
(i) Establish a tobacco-free school recognition awards program.
(j) As a condition of receiving funds pursuant to this article,
the State Department of Education, county offices of education, and
school districts shall ensure that they coordinate their efforts
toward smoking prevention and cessation with the lead local agency in
the community where the local school district is located.
(k) (1) Develop, in coordination with the county offices of
education, and administer a competitive grant program for
school-based, antitobacco education programs and tobacco use
intervention and cessation activities in order to reduce the number
of pupils who begin to use tobacco, continue to use tobacco, or both.
Grants shall be awarded, after consultation with local lead
agencies, the committee, and representatives of nonprofit
organizations dedicated to the reduction of tobacco-associated
disease, to school districts and county offices of education for all
pupils in grades 6 to 12, inclusive, that comply with the
requirements of paragraphs (2) and, if applicable, (3).
(2) Every school district and county office of education that
receives a grant pursuant to this section shall provide tobacco-use
prevention instruction that addresses all of the following essential
topics:
(A) Immediate and long-term undesirable physiologic, cosmetic, and
social consequences of tobacco use.
(B) Reasons that adolescents say they smoke or use tobacco.
(C) Peer norms and social influences that promote tobacco use.
(D) Refusal skills for resisting social influences that promote
tobacco use.
(3) Every school district and county office of education that
receives a grant pursuant to this section for pupils in grades 7 to
12, inclusive, shall provide tobacco-use intervention and cessation
activities targeted for pupils in high risk groups.
(4) The State Department of Education shall develop criteria and
standards for the allocation of grant awards that consider the need
to balance rural, suburban, and urban projects. In addition, the
State Department of Education shall give priority to applicants and
programs that do all of the following:
(A) Target current smokers and pupils most at risk for beginning
to use tobacco.
(B) Offer or refer pupils to cessation classes for current
smokers.
(C) Utilize existing antismoking resources, including local
antismoking efforts by local lead agencies and competitive grant
recipients.
(D) Design the project to coordinate with other community
services, including, but not limited to, local health agencies,
voluntary health organizations, and parent organizations.
(E) Design the project to use and develop existing services and
resources.
(F) Demonstrate an understanding of the role that the environment
and community norms play in influencing tobacco use.
(5) Available funds shall determine grant award amounts.
(l) Allocate funds to county offices of education to provide
technical assistance and leadership for tobacco use prevention,
intervention, and cessation programs. The funds shall be allocated to
all participating county offices of education at a minimum amount of
thirty-seven thousand five hundred dollars ($37,500). If funds
appropriated for purposes of allocating at least thirty-seven
thousand five hundred dollars ($37,500) to all participating county
offices of education are insufficient, the Superintendent of Public
Instruction shall prorate available funds among participating county
offices of education ensuring that all participating county offices
of education receive an equal minimum level of funding of
thirty-seven thousand five hundred dollars ($37,500). If funds are
sufficient to provide all participating county offices of education a
minimum of thirty-seven thousand five hundred dollars ($37,500), the
remaining funds shall be allocated according to the following
schedule based on average daily attendance in the prior year credited
to all elementary, high, and unified school districts, and to the
county superintendent of schools within the county as certified by
the Superintendent of Public Instruction:
(1) For counties with over 550,000 units of average daily
attendance, thirty cents ($0.30) per average daily attendance.
(2) For counties with more than 100,000 and less than 550,000
units of average daily attendance, sixty-five cents ($0.65) per
average daily attendance.
(3) For counties with more than 50,000 and less than 100,000 units
of average daily attendance, ninety cents ($0.90) per average daily
attendance.
(4) For counties with more than 37,500 and less than 50,000 units
of average daily attendance, one dollar ($1) per average daily
attendance.
(5) For counties with less than 37,500 units of average daily
attendance, thirty-seven thousand five hundred dollars ($37,500).
(m) Allocate funds appropriated by the act adding this subdivision
for local assistance to school districts and county offices of
education based on average daily attendance reported in the second
principal apportionment in the prior fiscal year.
(n) (1) Provide that all school districts and county offices of
education that receive funding under subdivision (m) make reasonable
progress toward providing a tobacco-free environment in school
facilities for pupils and employees.
(2) All school districts and county offices of education that
receive funding pursuant to paragraph (1) shall adopt and enforce a
tobacco-free campus policy no later than July of each fiscal year.
The policy shall prohibit the use of tobacco products, any time, in
district-owned or leased buildings, on district property and in
district vehicles. Information about the policy and enforcement
procedures shall be communicated clearly to school personnel,
parents, pupils, and the larger community. Signs stating "Tobacco use
is prohibited" shall be prominently displayed at all entrances to
school property. Information about smoking cessation support programs
shall be made available and encouraged for pupils and staff. Any
school district or county office of education that does not have a
tobacco-free district policy implemented by July 1, shall not be
eligible to apply for funds from the Cigarette and Tobacco Products
Surtax Fund for that fiscal year.
104430. (a) The State Department of Education shall make available
funds appropriated to it from the Health Education Account in the
Cigarette and Tobacco Products Surtax Fund for the implementation of
Section 104420 according to the following schedule:
(1) (A) Not less than two-thirds of that amount shall be awarded
to local educational agencies. Funds allocated pursuant to paragraphs
(2) and (3) shall not be considered funds for distribution to local
educational agencies.
(B) Not less than two hundred thousand dollars ($200,000) of the
amount subject to subparagraph (A) shall be made available for
proportionate awards to applicant education centers pursuant to
Article 6 (commencing with Section 33380) of Chapter 3 of Part 20 of
the Education Code, for tobacco use prevention projects.
(2) Not less than two hundred thousand dollars ($200,000) of the
amount awarded pursuant to Section 104420 shall be used for the
support of statewide program evaluation.
(3) Not more than nine hundred thousand dollars ($900,000) of the
amount awarded pursuant to Section 104420 shall be awarded as grants
for technical assistance, implementation strategies, and regional
coordinating activities related to tobacco use prevention pursuant to
subdivision (l) of Section 104420.
(b) Any amount that exceeds the amounts specified in subdivision
(a) shall be allocated for competitive grants pursuant to subdivision
(l) of Section 104420.
(c) On and after January 1, 1992, funding to which this section
applies shall be made available only upon a determination by the
Legislative Analyst and the Tobacco Education Oversight Committee, in
the evaluation required by subdivision (c) of Section 104375,
indicating that the tobacco use prevention program meets the purpose
of this article.
104435. County offices of education that receive funds pursuant to
subdivision (l) of Section 104420 shall do all of the following:
(a) Provide technical assistance and training to school districts
and consortia of school districts regarding planning and preparation
of antitobacco programs plans pursuant to State Department of
Education guidelines.
(b) Provide for appropriate coordination between school districts
programs and local antitobacco use programs funded by the local lead
agency.
(c) Participate in the review and scoring of applications
submitted by school districts for grant awards made pursuant to
Section 104420.
(d) Participate in the monitoring and technical assistance review
process for school districts and county offices of education pursuant
to Section 104455.
104440. Local lead agencies shall be ineligible for awards under
the competitive grants program, unless the local lead agency is
participant within a consortium of community-based organizations or
nonprofit organizations.
104445. In awarding grants under the competitive grants program,
the department shall give preference to all of the following:
(a) Nonprofit or community-based organizations.
(b) Current contractors that meet both of the following
requirements:
(1) Have demonstrated effectiveness and capacity in providing
tobacco education services.
(2) Serve populations and areas with substantial unmet service
needs.
(c) Proposals that provide new or expanded services to geographic
areas or target populations underserved, as determined by the
department.
104450. (a) The State Department of Education shall develop a
common reporting format for districts receiving
tobacco-use-prevention funds under this article.
(b) The format required by subdivision (a) shall be designed to
provide annual data on all of the following:
(1) Tobacco-use-prevention education program expenditures.
(2) Tobacco-use-prevention education program instructional and
other services to targeted and general student populations.
(3) Tobacco-use-prevention education program staff development and
parent training.
(4) Other information determined to be appropriate by the
department.
(c) The information provided by the format required by subdivision
(a) shall be in a quantitative format that describes the number of
individuals who are served and the number of individuals receiving
each type of service.
(d) In addition to the requirements of subdivision (c), the
information to be provided by the format required by subdivision (a)
shall include, at a minimum, all of the following:
(1) (A) The number of students receiving tobacco-use-prevention
instruction and the type of curriculum used.
(B) The format required by subdivision (a) shall show, by
category, those students listed for the purpose of subparagraph (A),
in each target group listed in Section 104360.
(2) Other programmatic activities directly targeted to students,
and the number of students participating in each.
(3) The types of staff development or other tobacco-use-prevention
training and, by staff classification, the number of staff members
receiving the training.
(4) The number of parents receiving training and the types of
training provided.
(5) The types of programs geared toward community involvement and
the number of people served by each type.
(6) The types of services provided to target populations that are
in addition to services provided to other students.
(7) The number and size of schools that are tobacco-free.
(8) The ways in which money appropriated for the purpose of this
article has been spent, including the following categories: salaries,
including, but limited to, personnel, and substitute teacher costs;
benefits; travel; consultant services; operating expenses, including,
but not limited to, curriculum and instructional materials,
supplies, other; capital outlay; and indirect costs.
(e) (1) Each county office of education shall provide to the State
Department of Education an annual report on district expenditures
and services within its respective county pursuant to the common
reporting format developed by the State Department of Education.
(2) The county shall provide an annual report of the information
required in paragraph (8) of subdivision (d).
104455. The State Department of Education shall monitor and ensure
implementation of district and county offices of education
tobacco-free policies and tobacco-use prevention education programs
in districts receiving funding from the Cigarette and Tobacco
Products Surtax Fund through procedures determined by the
Superintendent of Public Instruction after consultations with the
committee.
104460. (a) Each school district receiving funds from the Cigarette
and Tobacco Products Surtax Fund shall make all of the following
services available to every pregnant minor and minor parent enrolled
in the school district:
(1) Referral to perinatal and related support services.
(2) Outreach services and assessment of smoking status.
(3) Individualized counseling and advocacy services.
(4) Motivational messages.
(5) Cessation services, if appropriate.
(6) Incentives to maintain a healthy lifestyle.
(7) Followup assessment.
(8) Maintenance and relapse prevention services.
(b) Where appropriate, those services listed in subdivision (a)
shall be integrated with existing programs for pregnant minors and
minor parents.
(c) Each district plan submitted in application for funds under
this article shall include a description of the availability of the
services required by this section.
104465. (a) The department may annually set aside three million
dollars ($3,000,000) appropriated for the purposes of the competitive
grants program established pursuant to this article in order to
support efforts to link the statewide media campaign to local
communities and to provide regional public and community relations or
media initiatives.
(b) Local community initiatives may include, but are not limited
to, all of the following:
(1) Encouraging volunteer efforts.
(2) Local media programming.
(3) Provision of assistance in, and facilitation of, public and
community events.
(c) The efforts described in subdivision (b) shall be directed
principally to the target communities described in Section 104360.
(d) Regular application procedures for competitive grants under
this article shall apply to applications for grants under this
section.
(e) Funds awarded pursuant to this section shall be awarded in the
same manner as other competitive grants under this article.
104466. Notwithstanding subdivision (a) of Section 2.00 of the
Budget Act of 2002 and any other provision of law, commencing with
the appropriation for the 2002-03 fiscal year, and for each fiscal
year thereafter, any amount appropriated to the department to
implement the following tobacco use prevention programs shall be
available for encumbrance and expenditure for three fiscal years
beyond the date of the appropriation:
(a) The program to evaluate tobacco control programs provided for
in subdivisions (b) and (c) of Section 104375.
(b) The tobacco use prevention media campaign provided for in
subdivision (e) of Section 104375.
(c) The competitive grant program provided for in Section 104385.
(d) The local lead agency tobacco use prevention programs provided
for in Section 104400.
(e) The tobacco use prevention program directed at schools
provided for in Sections 104420, 104425, 104430, and 104435.
104470. The State Department of Education shall make periodic
reports to the committee regarding the status and funding of tobacco
education programs funded under this article as required by the
committee. The reports shall include an overview of program and grant
expenditures funded under this article.
104475. There is hereby created under the authority of the
Controller the Tobacco Education Fund.
104480. All guidelines, criteria, standards, and requirements
specified in this article are exempt from the requirements of Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, and shall be implemented without being
adopted as regulations.
104495. (a) For the purposes of this section, the following
definitions shall govern:
(1) "Playground" means any park or recreational area specifically
designed to be used by children that has play equipment installed, or
any similar facility located on public or private school grounds, or
on city, county, or state park grounds.
(2) "Tot lot sandbox area" means a designated play area within a
public park for the use by children under five years of age. Where
the area is not contained by a fence, the boundary of a tot lot
sandbox area shall be defined by the edge of the resilient surface of
safety material, such as concrete or wood, or any other material
surrounding the tot lot sandbox area.
(3) "Public park" includes a park operated by a public agency.
(4) "Smoke or smoking" means the carrying of a lighted pipe,
lighted cigar, or lighted cigarette of any kind, or the lighting of a
pipe, cigar, or cigarette of any kind, including, but not limited
to, tobacco, or any other weed or plant.
(5) "Cigarette" means the same as defined in Section 104556.
(6) "Cigar" means the same as defined in Section 104550.
(b) No person shall smoke a cigarette, cigar, or other
tobacco-related product within 25 feet of any playground or tot lot
sandbox area.
(c) No person shall dispose of cigarette butts, cigar butts, or
any other tobacco-related waste within 25 feet of a playground or a
tot lot sandbox area.
(d) No person shall intimidate, threaten any reprisal, or effect
any reprisal, for the purpose of retaliating against another person
who seeks to attain compliance with this section.
(e) Any person who violates this section is guilty of an
infraction and shall be punished by a fine of two hundred fifty
dollars ($250) for each violation of this section. Punishment under
this section shall not preclude punishment pursuant to Section 13002,
Section 374.4 of the Penal Code, or any other provision of law
proscribing the act of littering.
(f) The prohibitions contained in subdivisions (b), (c), and (d)
shall not apply to private property.
(g) The prohibitions contained in subdivisions (b) and (c) shall
not apply to a public sidewalk located within 25 feet of a playground
or a tot lot sandbox area.
(h) This section shall not preempt the authority of any county,
city, or city and county to regulate smoking around playgrounds or
tot lot sandbox areas. Any county, city, or city and county may
enforce any ordinance adopted prior to January 1, 2002, or may adopt
and enforce new regulations that are more restrictive than this
section, on and after January 1, 2002.
104350. (a) The Legislature finds and declares as follows:
(1) Smoking is the single most important source of preventable
disease and premature death in California.
(2) More than 30 percent of coronary heart disease cases are
attributable to cigarette smoking.
(3) More than 30 percent of all annual cancer deaths are
attributable to smoking, with lung cancer now the leading cancer
killer in women as well as men.
(4) Smoking is responsible for one-quarter of all deaths caused by
fire.
(5) Involuntary smoking is a cause of disease, including lung
cancer, in healthy nonsmokers.
(6) More than 80 percent of chronic obstructive lung diseases
including emphysema and chronic bronchitis are attributable to
smoking.
(7) Tobacco-related disease places a tremendous financial burden
upon the persons with the disease, their families, the health care
delivery system, and society as a whole. California spends five
billion six hundred million dollars ($5,600,000,000) a year in direct
and indirect costs on smoking-related illnesses.
(8) The elimination of smoking is the number one weapon against
four of the five leading causes of death in California.
(9) Keeping children and young adults from beginning to use
tobacco and encouraging all persons to quit tobacco use shall be the
highest priority in disease prevention for the State of California.
More than 60 percent of all smokers begin smoking by the age of 14,
and 90 percent begin by the age of 19.
(10) The State of California shall play a leading role in
promoting a smoke-free society by the year 2000 and thereby
supporting the National Health Status Objectives for the year 2000
relating to smoking and tobacco use.
(b) It is the intent of the Legislature, therefore, to require the
department, local lead agencies, and the State Department of
Education to cooperatively and individually conduct activities
directed at the prevention of tobacco use and tobacco-related
diseases. The campaign shall focus on health promotion, disease
prevention, and risk reduction, utilizing a "wellness" perspective
that encourages self-esteem and positive decisionmaking techniques.
It is also the intent of the Legislature that, for the purpose of
program planning and program evaluation, the department provide data
and technical information on tobacco-related diseases, tobacco use
and its consequences, and effective personal and community
interventions to prevent tobacco use.
104355. The following definitions shall apply to this article:
(a) "Grantee" means any public or private nonprofit entity
approved by the department or the State Department of Education to
receive funds pursuant to this article. Grantees may include, but are
not limited to, hospitals, community clinics, local health
departments, voluntary health organizations, Indian tribes, colleges
and universities, county offices of education, school districts,
health maintenance organizations, professional health associations,
and professional health education associations.
(b) "Tobacco-related disease" means any of the following:
(1) Coronary heart disease.
(2) Cerebrovascular disease.
(3) Cancer, including cancers of the lung, larynx, esophagus,
bladder, pancreas, and mouth.
(4) Chronic obstructive lung diseases, including emphysema,
chronic bronchitis, asthma, and related lung disorders.
(5) Conditions where smoking or tobacco use has been determined to
be a risk factor for excess disability and illness, including burns
due to smoking-related fires.
(c) "Tobacco use" means the consumption of tobacco products by
burning, chewing, inhalation, or other forms of ingestion.
(d) "Voluntary health organization" means a nonprofit organization
organized for purposes related to health, including, but not limited
to, an organization devoted to the research of cancer, heart
disease, or diseases of the lung.
(e) "Committee" means the Tobacco Education Oversight Committee.
(f) "The department" means the State Department of Health
Services.
(g) "Service provider" means an agency or organization that enters
into an agreement with the local lead agency or state department to
provide services under this article.
(h) "Direct services" means the provision of preventive health
education services to targeted populations.
(i) "Local plan" means a plan submitted pursuant to Section
104400.
(j) "Preventive health education against tobacco use" means
programs of instruction intended to dissuade individuals from
beginning to smoke, to encourage smoking cessation, or to provide
information on the health effects of tobacco on the user, children,
and nonsmokers. These programs may include a focus on health
promotion, disease prevention, and risk reduction, utilizing a
"wellness perspective" that encourages self-esteem and positive
decisionmaking techniques.
(k) "Targeted populations" means those population groups specified
in Sections 104360 and 104385.
( l) "Local lead agencies" means those agencies designated as
local lead agencies pursuant to Section 104400.
104360. The following target populations, at a minimum, shall be
the focus of the campaign implemented pursuant to this article:
(a) School-age youth and their families in the schools and in the
community.
(b) Black, Hispanic, Native American, and Asian-Pacific American
populations, pregnant women, and current smokers.
104365. (a) There is hereby created the Tobacco Education and
Research Oversight Committee in state government that shall advise
the department and the State Department of Education with respect to
policy development, integration, and evaluation of tobacco education
programs funded under this article, and for development of a master
plan for the future implementation of tobacco education programs.
(b) The Tobacco Education Oversight Committee shall be composed of
13 members to be appointed as follows:
(1) Two members representing volunteer health organizations
dedicated to the reduction of tobacco use appointed by the Speaker of
the Assembly.
(2) One member representing an organization that represents health
care employees appointed by the Senate Rules Committee.
(3) One member of a professional education association, such as an
association of teachers, appointed by the Senate Rules Committee.
(4) One member of a university facility with expertise in programs
intended to reduce tobacco use appointed by the Governor.
(5) Two representatives of a target population group appointed by
the Governor.
(6) One representative of the department appointed by the
Governor.
(7) One representative of the State Department of Education
appointed by the Superintendent of Public Instruction.
(8) One member representing the interests of the general public
appointed by the Governor.
(9) One representative of local health departments appointed by
the Governor.
(10) One member representing a volunteer health organization
dedicated to the reduction of tobacco associated injury appointed by
the Governor.
(11) One member from the Tobacco Related Disease Research Program
appointed by the Governor.
(c) Members shall serve for a term of two years, renewable at the
option of the appointing authority. The initial appointments of
members shall be for two or three years, to be drawn by random lot at
the first meeting. The committee shall be staffed by the department'
s coordinator of the program created pursuant to Section 104375.
(d) The committee shall meet as often as it deems necessary, but
shall meet not less than four times per year.
(e) The members of the committee shall serve without compensation,
but shall be reimbursed for necessary travel expenses incurred in
the performance of the duties of the committee.
104370. The committee shall be advisory to the department, the
University of California, and State Department of Education for the
following purposes:
(a) Evaluation of research, school- and community-based programs
funded under this article as necessary in order to assess the overall
effectiveness of efforts made by the programs to reduce the use of
tobacco products. In order to evaluate tobacco education, research,
and cessation programs, the committee shall seek the cooperation and
assistance of the department, the State Department of Education,
county offices of education, local lead agencies, administrative
representatives, target populations, school officials, and
researchers. A principal measurement of effectiveness shall be
reduction of smoking rates among a given target population.
(b) Facilitation of programs directed at reducing and eliminating
tobacco use that are operated jointly by more than one agency or
entity. The committee shall propose strategies for the coordination
of proposed programs administered by the department, the University
of California, and the State Department of Education in order to
avoid the duplication of services and to maximize the public benefit
of the programs.
(c) Make recommendations to the department, the University of
California, and the State Department of Education regarding the most
appropriate criteria for the selection of, standards of the operation
of, and the types of programs to be funded under this article.
(d) Reporting to the Legislature on or before January 1 of each
year on the number and amount of tobacco education programs funded by
the Health Education Account, created by Section 30122 of the
Revenue and Taxation Code, the amount of money in the account, any
moneys previously appropriated to the department, the University of
California, and the State Department of Education but unspent by the
departments, a description and assessment of all programs funded
under this article, and recommendations for any necessary policy
changes or improvements for tobacco education programs.
(e) Ensuring that the most current research findings regarding
tobacco use prevention are applied in designing the tobacco education
programs administered by the department and the State Department of
Education. The department and the State Department of Education shall
apply the most current findings and recommendations of research
including research funded by the Research Account of the Cigarette
and Tobacco Products Surtax Fund created by Section 30122 of the
Revenue and Taxation Code.
(f) Based on the results of programs supported by this article and
any other proven methodologies available to the committee, produce a
comprehensive master plan for implementing tobacco education
programs throughout this state for the prevention and cessation of
tobacco use. The master plan shall include implementation strategies
for each target population specified in Section 104360 for programs
throughout this state. The Tobacco Education and Research Oversight
Committee shall submit the master plan to the Legislature biennially.
The master plan and its revisions shall include recommendations on
administrative arrangements, funding priorities, integration and
coordination of approaches by the department, the University of
California, and the State Department of Education and their support
systems, as well as progress reports relating to each target
population. The master plan shall establish a goal of achieving a
75-percent reduction in tobacco consumption in California by the year
1999.
104375. (a) To prevent tobacco-related diseases and diminish
tobacco use, the department shall establish within the department a
program on tobacco use and health to reduce tobacco use in California
by conducting health education interventions and behavior change
programs at the state level, in the community, and other nonschool
settings.
(b) The department shall conduct statewide surveillance of
tobacco-related behaviors, knowledge, and attitudes and evaluate the
department's local and state tobacco control programs under this
article. At a minimum, these evaluation activities shall utilize
scientifically appropriate methods for monitoring the annual progress
of the program in reducing the adult smoking prevalence from the
1993 benchmark rate of 20 percent and reducing cigarette consumption
from the 1993 per capita benchmark rate of 4.84 packs per quarter.
These surveillance and evaluation activities may include, but need
not be limited to, the following:
(1) Be based on sound evaluation principles and include, to the
extent feasible, elements of controlled experimental methods.
(2) Monitor the overall statewide effect of health education
efforts on smoking and tobacco use, and, to the extent feasible, the
resulting effects on health.
(3) Monitor the effect of the programs on individual target
populations identified by this article or designated by the
department as meriting special attention.
(4) Provide an evaluation of the comparative effectiveness of
individual program designs that shall be used in funding decisions
and program modifications.
(5) Incorporate other aspects into the evaluation that have been
identified by the department in consultation with state and local
advisory groups, local lead agencies, and other interested parties.
(6) Funds permitting, utilize a sample size that is adequate to
produce county, regional, and ethnic specific estimates.
(c) The department shall produce or contract for, and update
biennially, a description of programs determined to be effective in
reducing smoking and tobacco use, and the identification of portions
of target populations that need information regarding the hazards of
tobacco use. The department, in consultation with the State
Department of Education, shall conduct, or contract for an evaluation
of the effectiveness of the tobacco use prevention and education
program as implemented in the public schools that receive funding for
tobacco use prevention education pursuant to Sections 104420,
104425, 104435, and 104445. The purpose of the evaluation shall be to
direct the most efficient allocation of resources appropriated under
this article to accomplish the maximum prevention and reduction of
tobacco use. The comprehensive evaluation shall be designed to
measure the extent to which programs funded pursuant to this article
promote the goals identified in this article and in Proposition 99 of
the November 1988 general election. All information resulting from
the evaluation shall be made available to the State Department of
Education for purposes of improving its ability to implement and
oversee the provision of effective tobacco use prevention education
programs. The evaluator shall:
(1) Assess the effectiveness of tobacco use prevention education
programs designed to prevent and reduce tobacco use among students.
In support of this primary goal, the evaluation shall:
(A) Report findings on the effectiveness of programs and
strategies currently in use in California schools that prevent and
reduce tobacco use.
(B) Select a research strategy that will identify formal and
informal factors that might account for differences in tobacco use by
students, including, but not limited to, formal education prevention
strategies.
(C) Incorporate in the evaluation quantitative as well as
qualitative data. The data shall include, but are not limited to:
(i) Student data, including attitudes, knowledge, and behavior
based upon a statistically valid random sample of school districts
and students.
(ii) Curriculum data, including diversity of curricula, evidence
of appropriateness to grade level, gender, and ethnicity, and the
extent of the inclusion of prevention approaches identified in
research literature.
(iii) School data, including intensity of emphasis on tobacco use
prevention and evidence of counseling or treatment referral systems.
(iv) Community data, including the existence of parent networks
and the participation of community service organizations including
local lead agencies, in prevention.
(2) Develop and test a regular tobacco use prevention and
education information system for use by the State Department of
Education, using the resulting information to establish the extent of
implementation of tobacco use prevention education programs
statewide and the degree of student exposure to these programs at
selected grade levels.
(3) Ensure provision of a fourth administration of a statewide,
biennial survey of attitudes toward tobacco and prevalence of tobacco
use among public school students. To the extent possible, existing
survey data shall be utilized.
(4) Provide recommendations to the Legislature and the State
Department of Education on tobacco use prevention education program
changes.
(5) Assist the State Department of Education in identifying and
developing instructional materials and curricula in school-based
programs, designed to enhance the prevention of and encouraging the
cessation of the continuing use of, tobacco products. The materials
and curricula shall address the specific needs of persons in grades 4
to 12, inclusive, and in adult education programs.
(d) School districts shall agree, as a condition of receiving
money pursuant to this article, to participate in the evaluation if
chosen by the evaluator.
(e) (1) The department shall contract with one or more qualified
agencies for production and implementation of an ongoing public
awareness of tobacco-related diseases by developing an information
campaign using a variety of media approaches. The department shall
issue a request for proposals biennially. Any media campaign funded
with this part shall stress the importance of both preventing the
initiation of tobacco use and quitting smoking and shall be based on
professional market research and surveys necessary to determine the
most effective method of diminishing tobacco use among specified
target populations. Initial media efforts shall be directed to
specific target populations. The contractors selected shall be
provided with all available survey information resulting from ongoing
programs funded under this article. Priority shall be given to minor
children, ages 6 to 14, inclusive. The medium used shall be
determined to be the most effective at reaching this targeted age
group. With respect to the broadcast media, the message shall be
aired at times expected to reach the priority age group. With respect
to the print media, publications to be used shall be those that
appeal to the priority age group.
(2) No media campaign funded pursuant to this article shall
feature in any manner the image or voice of any elected public
official or candidate for elected office, or directly represent the
views of any elected public official or candidate for elected office.
(f) The department shall provide or contract for training,
consultation, support, and continuing education to health
professionals, and others interested in developing programs and
services directed at preventing tobacco use and promoting smoking
cessation, utilizing, when available and determined appropriate by
the department, the expertise of universities in this state and
schools of public health. The training, consultation, support, and
continuing education shall include advice and support in creating a
smoke-free environment.
(g) The department shall conduct an awards program to acknowledge
the outstanding achievements of those communities, organizations, and
groups that have fostered movement toward a smoke-free society or
have reduced the consumption of tobacco.
(h) The department shall issue guidelines for local plans for
education against tobacco use. The guidelines shall require local
public health departments to provide services directed at preventing
tobacco use and promoting smoking cessation to the target populations
enumerated in Section 104360 and to persons under 19 years of age
who no longer attend school and to youth attending school who are not
served through State Department of Education funded programs. The
guidelines shall require for each target population to be served a
description of the services to be provided, an estimate of the number
to be served, an estimate of the success rate, and a method to
determine to what extent goals have been achieved. Beginning with the
1990-91 fiscal year, and for each fiscal year thereafter, the
guidelines shall require local lead agencies to describe how local
funding decisions will take into account evaluations of program
effectiveness and efficiency. The guidelines shall require the
submission of a budget and information on staffing configurations.
(i) By December 31, 1989, the department shall issue guidelines
for fiscal year 1989-90 and by July 1, 1990, the department shall
issue guidelines to local lead agencies on how to prepare a local
plan for a comprehensive community intervention program against
tobacco use.
(j) The department shall provide technical assistance to local
lead agencies for the development of plans required by Section 104400
so that the local lead agencies are able to comply with the schedule
for the submission of plans specified in Section 104400. The
technical assistance shall include, but not be limited to, the
following:
(1) Developing and disseminating preventive health education
program options for local communities.
(2) Providing training, consultation, and technical assistance to
local health departments, local advisory committees, and service
providers.
(k) The department shall receive and approve local plans submitted
by local lead agencies and provide technical assistance and guidance
as necessary to ensure the compliance of the local lead agencies
with this article. Every effort shall be made to approve or provide a
list of necessary amendments to a local plan within 30 days of
receipt of the local plan. The department may authorize a local lead
agency to begin implementation of its local plan on a provisional
basis, with final approval of the local plan contingent on satisfying
conditions specified by the department.
( l) The department shall work in collaboration with the public
and private sectors in implementing the activities required of the
department and provide access upon request to local plans, program
statistics, and other readily available information.
(m) The department shall provide staff, assistance, and support
needed by the committee.
(n) In consultation with the committee, the department shall
develop a comprehensive master plan for implementing tobacco
education programs throughout the state for the prevention and
cessation of tobacco use.
(o) The department shall consult regularly with the University of
California regarding trends in the frequency and the cost of treating
tobacco-related diseases and the success of research efforts to
reduce tobacco use and limit its adverse health effects.
(p) The department shall establish, in consultation with the State
Department of Education and county offices of education, a data
collection and data management program to study effective tobacco use
interventions. Under this program the department may contract for
studies and evaluations in school-based and community-based programs.
The department shall consult with the State Department of Education
regarding the collection and evaluation of program data.
(1) The department shall require, by contract, that local lead
agencies use a uniform management data and information system that
will permit comparisons of workload, unit costs, and outcome
measurements on a statewide basis. The department shall specify data
reporting requirements for local lead agencies and their
subcontractors.
(2) The department shall approve local lead agency and grantee
computer software and hardware in order to ensure systemwide
compatibility and capacity to expand. Departmental guidelines for
local plans shall require local lead agencies to set forth their
hardware and software plans and needs.
(3) The department may contract for the development or operation
of a computerized management information system.
(4) The department shall consult the State Department of Education
regarding computer software and hardware systems for school-based
programs.
104380. (a) Funds appropriated to the department for local lead
agencies for purposes of this article shall be allocated
prospectively, on a quarterly basis in accordance with this section.
(b) No local lead agency shall be allocated less than one hundred
fifty thousand dollars ($150,000).
(c) (1) Except as provided in subdivision (b), counties not listed
in subdivision (d) shall receive an allocation based on each county'
s proportion of the statewide population.
(2) Counties that receive their allocations pursuant to paragraph
(1) shall receive 73 percent of their 1990-91 fiscal year allocation.
(d) Except as provided in subdivision (b), the balance of the
funds after the allocation contained in subdivision (c) have been
made, shall be allocated to the following specified counties in
accordance with the following percentages:
COUNTY ALLOCATION
Alameda 4.7427%
Contra Costa 1.8032%
Fresno 2.6855%
Kern 1.7083%
Lake 0.1826%
Los Angeles 43.8057%
Mendocino 0.2664%
Merced 0.7244%
Monterey 1.2937%
Orange 5.1382%
Placer 0.3697%
Riverside 3.1828%
Sacramento 3.2922%
San Bernardino 3.7972%
San Diego 5.9971%
San Francisco 5.3898%
San Joaquin 1.7413%
San Luis Obispo 0.8096%
San Mateo 1.4582%
Santa Barbara 0.7918%
Santa Clara 5.2450%
Santa Cruz 0.7709%
Stanislaus 1.2793%
Tulare 1.3768%
Ventura 1.5472%
Yolo 0.6004%
(e) Except as provided in subdivision (b), the allocation for
those counties in which a city health department which is a local
lead agency as defined by subdivision ( l) of Section 104355 is
located shall be apportioned among the local lead agencies in that
county based on their jurisdiction's proportionate share of the
countywide population.
(f) Reductions in allocations necessary to comply with subdivision
(b) shall be distributed among the counties listed in subdivision
(d) proportionately based on the table contained in subdivision (d).
(g) The department shall use population estimates for 1989 for
each county and for each city as specified in the Department of
Finance E-1 Report.
(h) Payments shall be made prospectively, on a quarterly basis, to
local jurisdictions.
(i) (1) The department shall conduct a fiscal and program review
on a regular basis.
(2) If the department determines that any county is not in
compliance with any provision of this chapter, the county shall
submit to the department, within 60 days, a plan for complying with
this article.
(3) The department may withhold funds from local lead agencies
allocated funds under this section that are not in compliance with
this chapter in the same manner as the department is authorized under
Chapter 5 (commencing with Section 16940) of Part 4.7 of Division 9
of the Welfare and Institutions Code. The department may terminate
the agreement with the noncompliant local lead agency, recoup any
unexpended funds from the noncompliant local lead agency, and
reallocate both the withheld and recouped funds to provide services
available under this section to the jurisdiction of the noncompliant
agency through an agreement with a different governmental or private
nonprofit agency capable of delivering those services based on the
department's local lead agency guidelines for local plans and a
process determined by the department. The department may encumber and
reallocate these funds no sooner than three months after the date of
the first notification that the department has determined the local
lead agency to be out of compliance with statutory requirements.
104385. (a) The department shall award and administer grants for
projects directed at the prevention of tobacco-related diseases. The
purpose of the grant program is to conduct health education and
promotion activities targeted to high-risk persons and groups in
order to reduce the number of persons beginning to use tobacco,
continuing to use tobacco, or developing tobacco-related diseases.
The grants shall provide funds to eligible grantees, as determined by
the department. In awarding grants, the department shall select a
variety of projects and grantees.
(b) The department shall develop criteria and standards for the
allocation of grant awards which consider the need to balance target
populations to be served, project types of rural suburban and urban
projects, and consider the current regional availability of similar
services. Target populations may include, but not be limited to,
children, young adults, pregnant women, low-income individuals,
Black, Hispanic, Native American, and Asian-Pacific Islander
populations, current smokers, and schoolaged youth no longer
attending school classes. The grant awards may also be made to school
districts for nonclassroom, districtwide efforts to reduce tobacco
use. The department shall develop mechanisms to evaluate all programs
and shall require any program funded under this article to provide
statistics on the impact of the program.
(c) The department shall give priority to grantees who do the
following:
(1) Demonstrate community support for the project.
(2) Design the project to coordinate with other community services
including local health programs, school-based programs, or voluntary
health organizations.
(3) Design the project to utilize and enhance existing services
and resources.
(4) Serve a target population at high risk of starting tobacco use
or developing tobacco-related illnesses.
(5) Demonstrate an understanding of the role community norms have
in influencing behavioral change regarding tobacco use.
(6) Indicate promising innovative approaches to diminishing
tobacco use among target groups and permit those approaches to be
replicated by others.
(d) Of the funds appropriated to the department in Item
4260-111-231 of the 1996 Budget Act, five million dollars
($5,000,000) shall be available specifically for grants awarded on a
competitive basis to provide smoking cessation classes or services
for persons eligible for and enrolled in the state's Medi-Cal
program, or persons who are medically indigent.
104390. (a) The department may provide program support services to
local tobacco use prevention programs, that shall include, but need
not be limited to, all of the following:
(1) Data collection.
(2) Educational materials.
(3) Evaluation.
(4) Technical assistance.
(5) Training.
(6) Transfer of information among programs.
(b) Services funded under this section may be awarded through a
competitive request for proposal process or directly to another state
agency, the Regents of the University of California, the federal
government, or an auxiliary organization of the California State
University.
(c) Grantees of services under this section shall demonstrate the
ability to do both of the following:
(1) Improve the delivery of local tobacco use prevention programs
directed at the targeted populations.
(2) Design programs to provide statewide and regional services to
support local implementation of tobacco use prevention programs.
104395. The department shall expand the Child Health and Disability
Prevention (CHDP) Program contained in Article 6 (commencing with
Section 124025) of Chapter 3 of Part 2 of Division 106 as follows:
(a) Any child between birth and 90 days after entrance into first
grade, all persons under 21 years of age who are eligible for the
California Medical Assistance Program, and any person under 19 years
of age whose family income is not more than 200 percent of the
federal poverty level shall be eligible for services under the
program in the county of which they are a resident. The department
shall adopt regulations specifying which age groups shall be given
certain types of screening tests and recommendations for referral.
(b) The first source of referral under the program shall be the
child's usual source of health care. If referral is required and no
regular source of health care can be identified, the facility or
provider providing health screening and evaluation services shall
provide a list of three qualified sources of care, without prejudice
for or against any specific source.
(c) The department shall issue protocols for an antitobacco
education component of the child health and disability prevention
medical examination. The protocols shall include the following:
dissuading children from beginning to smoke, encouraging smoking
cessation, and providing information on the health effects of tobacco
use on the user, children, and nonsmokers. The protocols shall also
include a focus on health promotion, disease prevention, and risk
reduction, utilizing a "wellness" perspective that encourages
self-esteem and positive decisionmaking techniques, and referral to
an appropriate community smoking cessation program.
(d) Notwithstanding any other provision of law, the department
shall ensure that a portion of the funds in the Child Health
Disability Prevention Program budget is used to facilitate the
integration of the medical and dental components of all aspects of
that program.
(e) The department shall expand its support and monitoring of
county child health and disability prevention program efforts to
provide all of the following:
(1) Review of a representative, statistically valid, randomly
selected sample of child health and disability prevention health
assessments, including, but not limited to, dental assessments, which
result in the discovery of conditions which require followup
diagnosis and treatment, including but not limited to dental
treatment, and which qualify for services under this section. The
purpose of the survey and followup reviews of local programs is to
determine whether necessary diagnosis and treatment services are
being provided, and the degree to which those services comply with
the intent of the act that added this subdivision. These survey
reviews shall include all counties and shall be conducted at least
three times a year.
(2) At least once a year, as part of regular visits to county
child health and disability prevention programs to provide technical
assistance, support services and monitoring and evaluation of program
performance, department staff shall review the effectiveness of the
mandated treatment program. The purpose of this review is to assure
that the county is providing appropriate followup services for
conditions discovered during child health and disability prevention
health assessments. This review shall be done in conjunction with the
ongoing survey activity of the Child Health and Disability
Prevention Branch of the department and shall utilize data resulting
from that activity.
(3) If the department establishes that a county has failed to
provide treatment services mandated by the act that added this
subdivision, the department shall require the county to submit a plan
of correction within 90 days. If the department finds that
substantial correction has not occurred within 90 days following
receipt of the correction plan, it may require the county to enter
into a contract pursuant to Section 16934.5 of the Welfare and
Institutions Code for the remainder of the fiscal year and the
following fiscal year, and for this purpose shall withhold the same
percentage of funds as are withheld from other counties participating
in the program pursuant to Section 16934.5 of the Welfare and
Institutions Code.
104400. (a) (1) Except as provided in paragraph (2), each county
health department or city health department as provided in Section
16800 of the Welfare and Institutions Code shall be the lead local
agency for its county. The local lead agency shall have the overall
responsibility for the success of the programs funded pursuant to
this article in its county.
(2) Counties contracting with the department for the provision of
health care services pursuant to Section 16809 of the Welfare and
Institutions Code may elect to enter into an arrangement with the
department for the administration and provision of funds and services
subject to this article in their counties. In those cases, the
department shall act as the local lead agency for that county.
(b) The local lead agency shall do all of the following:
(1) Provide, or contract for, preventive health education against
tobacco services to targeted populations.
(2) Establish a coordinated information, referral, outreach, and
intake system for preventive health education against tobacco
services for targeted populations.
(3) Administer funds in accordance with this article, and
department guidelines.
(4) Establish a uniform data collection system in compliance with
standards and guidelines issued by the department, and submit audit
and fiscal reports as required by the department.
(5) Coordinate services authorized by this article within and
between county service providers.
(6) Provide technical assistance to service providers.
(7) Review, and suggest improvements to proposed county school
district antitobacco plans. Prepare a letter for the county officer
of education setting forth conclusions of the review. Work closely
with the county office of education to ensure effective coordination
of local school and nonschool antitobacco efforts.
(8) Coordinate activities with other governmental agencies.
(c) The local plans described in paragraph (4) of subdivision (b)
shall include all of the following:
(1) A description of the targeted population, including age, race,
ethnicity, language, education, income levels, its status as urban
or rural, transportation needs, and any other information which the
local lead agency determines is relevant.
(2) Local data on smoking and tobacco use among the targeted
population.
(3) Goals for how many persons of the targeted population will be
reached by health education, how many will participate in a smoking
prevention or cessation program, and how many will quit or not start
smoking as a result.
(4) A description of the direct services to be provided under the
plan, including the services to be provided to the targeted
populations enumerated in Section 104360 and schoolage youth who do
not receive services through public school programs.
(5) Cost estimates for programs identified in the plan.
104405. Local lead agencies shall obtain the involvement and
participation of local community organizations with special
experience and expertise in community health education against
tobacco usage, including representatives of high-risk populations.
Local lead agencies shall include in their plan submitted pursuant to
Section 104400 a description of how they shall fulfill this
requirement. Representatives of these local groups shall assist and
advise the local lead agency in all aspects of the local plan
implemented pursuant to this article.
104410. The following goals and priorities shall govern funding
services provided under this article pursuant to local plans:
(a) The provisions of preventive health education against tobacco
use aimed at targeted populations, including pregnant women, mothers
of young children, and minorities, school dropouts, and other
school-aged youth who would otherwise be unserved.
(b) The provisions of preventive health education against tobacco
use aimed at school-age youth and their families in the community.
(c) The provision of preventive health education against tobacco
use aimed at the workplace and the community.
104415. (a) Local lead agencies shall attempt to ensure that
preventive education against tobacco use for targeted populations is
provided in a way that reaches all geographic areas of the county.
(b) In choosing among eligible service providers available to
serve the targeted populations described in subdivision (a), the
local lead agency shall give priority to programs presently providing
preventive health education, case management services to the
targeted populations which are compatible with preventive health
education against tobacco use, or other services in which preventive
health education against tobacco use can be incorporated in a logical
and efficient manner.
104420. The State Department of Education shall provide the
leadership for the successful implementation of this article in
programs administered by local public and private schools, school
districts, and county offices of education. The State Department of
Education shall do all of the following:
(a) Provide a planning and technical assistance program to carry
out its responsibilities under this article.
(b) Provide guidelines for schools, school districts, and school
district consortia to follow in the preparation of plans for
implementation of antitobacco use programs for schoolage populations.
The guidelines shall:
(1) Require the applicant agency to select one or more model
program designs and shall permit the applicant to modify the model
program designs to take special local needs and conditions into
account.
(2) Require the applicant agency to prepare for each target
population to be served a description of the service to be provided,
an estimate of the number to be served, an estimate of the success
rate and a method to determine to what extent goals have been
achieved.
(3) Require plan submissions to include a staffing configuration
and a budget setting forth use and distribution of funds in a clear
and detailed manner.
(c) Prepare model program designs and information for schools,
school districts, consortia, and county offices of education to
follow in establishing direct service programs to targeted
populations. Model program designs shall, to the extent feasible, be
based on studies and evaluations that determine which service
delivery systems are effective in reducing tobacco use and are cost
effective. The State Department of Education shall consult with the
department, and school districts with existing antitobacco programs
in the preparation of model program designs and information.
(d) Provide technical assistance for schools, school districts,
and county offices of education regarding the prevention and
cessation of tobacco use. In fulfilling its technical assistance
responsibilities, the State Department of Education may establish a
center for tobacco use prevention that shall identify, maintain, and
develop instructional materials and curricula encouraging the
prevention or cessation of tobacco use. The State Department of
Education shall consult with the department and others with expertise
in antitobacco materials or curricula in the preparation of these
materials and curricula.
(e) Monitor the implementation of programs that it has approved
under this article to ensure successful implementation.
(f) Prepare guidelines within 180 days of the effective date of
this article for a school-based program of outreach, education,
intervention, counseling, peer counseling, and other activities to
reduce and prevent smoking among schoolage youth.
(g) Assist county offices of education to employ a tobacco use
prevention coordinator to assist local schools and local public and
community agencies in preventing tobacco use by pupils.
(h) Train the tobacco use prevention coordinators of county
offices of education so that they are:
(1) Familiar with relevant research regarding the effectiveness of
various kinds of antitobacco use programs.
(2) Familiar with department guidelines and requirements for
submission, review, and approval of school-based plans.
(3) Able to provide effective technical assistance to schools and
school districts.
(i) Establish a tobacco-free school recognition awards program.
(j) As a condition of receiving funds pursuant to this article,
the State Department of Education, county offices of education, and
school districts shall ensure that they coordinate their efforts
toward smoking prevention and cessation with the lead local agency in
the community where the local school district is located.
(k) (1) Develop, in coordination with the county offices of
education, and administer a competitive grant program for
school-based, antitobacco education programs and tobacco use
intervention and cessation activities in order to reduce the number
of pupils who begin to use tobacco, continue to use tobacco, or both.
Grants shall be awarded, after consultation with local lead
agencies, the committee, and representatives of nonprofit
organizations dedicated to the reduction of tobacco-associated
disease, to school districts and county offices of education for all
pupils in grades 6 to 12, inclusive, that comply with the
requirements of paragraphs (2) and, if applicable, (3).
(2) Every school district and county office of education that
receives a grant pursuant to this section shall provide tobacco-use
prevention instruction that addresses all of the following essential
topics:
(A) Immediate and long-term undesirable physiologic, cosmetic, and
social consequences of tobacco use.
(B) Reasons that adolescents say they smoke or use tobacco.
(C) Peer norms and social influences that promote tobacco use.
(D) Refusal skills for resisting social influences that promote
tobacco use.
(3) Every school district and county office of education that
receives a grant pursuant to this section for pupils in grades 7 to
12, inclusive, shall provide tobacco-use intervention and cessation
activities targeted for pupils in high risk groups.
(4) The State Department of Education shall develop criteria and
standards for the allocation of grant awards that consider the need
to balance rural, suburban, and urban projects. In addition, the
State Department of Education shall give priority to applicants and
programs that do all of the following:
(A) Target current smokers and pupils most at risk for beginning
to use tobacco.
(B) Offer or refer pupils to cessation classes for current
smokers.
(C) Utilize existing antismoking resources, including local
antismoking efforts by local lead agencies and competitive grant
recipients.
(D) Design the project to coordinate with other community
services, including, but not limited to, local health agencies,
voluntary health organizations, and parent organizations.
(E) Design the project to use and develop existing services and
resources.
(F) Demonstrate an understanding of the role that the environment
and community norms play in influencing tobacco use.
(5) Available funds shall determine grant award amounts.
(l) Allocate funds to county offices of education to provide
technical assistance and leadership for tobacco use prevention,
intervention, and cessation programs. The funds shall be allocated to
all participating county offices of education at a minimum amount of
thirty-seven thousand five hundred dollars ($37,500). If funds
appropriated for purposes of allocating at least thirty-seven
thousand five hundred dollars ($37,500) to all participating county
offices of education are insufficient, the Superintendent of Public
Instruction shall prorate available funds among participating county
offices of education ensuring that all participating county offices
of education receive an equal minimum level of funding of
thirty-seven thousand five hundred dollars ($37,500). If funds are
sufficient to provide all participating county offices of education a
minimum of thirty-seven thousand five hundred dollars ($37,500), the
remaining funds shall be allocated according to the following
schedule based on average daily attendance in the prior year credited
to all elementary, high, and unified school districts, and to the
county superintendent of schools within the county as certified by
the Superintendent of Public Instruction:
(1) For counties with over 550,000 units of average daily
attendance, thirty cents ($0.30) per average daily attendance.
(2) For counties with more than 100,000 and less than 550,000
units of average daily attendance, sixty-five cents ($0.65) per
average daily attendance.
(3) For counties with more than 50,000 and less than 100,000 units
of average daily attendance, ninety cents ($0.90) per average daily
attendance.
(4) For counties with more than 37,500 and less than 50,000 units
of average daily attendance, one dollar ($1) per average daily
attendance.
(5) For counties with less than 37,500 units of average daily
attendance, thirty-seven thousand five hundred dollars ($37,500).
(m) Allocate funds appropriated by the act adding this subdivision
for local assistance to school districts and county offices of
education based on average daily attendance reported in the second
principal apportionment in the prior fiscal year.
(n) (1) Provide that all school districts and county offices of
education that receive funding under subdivision (m) make reasonable
progress toward providing a tobacco-free environment in school
facilities for pupils and employees.
(2) All school districts and county offices of education that
receive funding pursuant to paragraph (1) shall adopt and enforce a
tobacco-free campus policy no later than July of each fiscal year.
The policy shall prohibit the use of tobacco products, any time, in
district-owned or leased buildings, on district property and in
district vehicles. Information about the policy and enforcement
procedures shall be communicated clearly to school personnel,
parents, pupils, and the larger community. Signs stating "Tobacco use
is prohibited" shall be prominently displayed at all entrances to
school property. Information about smoking cessation support programs
shall be made available and encouraged for pupils and staff. Any
school district or county office of education that does not have a
tobacco-free district policy implemented by July 1, shall not be
eligible to apply for funds from the Cigarette and Tobacco Products
Surtax Fund for that fiscal year.
104430. (a) The State Department of Education shall make available
funds appropriated to it from the Health Education Account in the
Cigarette and Tobacco Products Surtax Fund for the implementation of
Section 104420 according to the following schedule:
(1) (A) Not less than two-thirds of that amount shall be awarded
to local educational agencies. Funds allocated pursuant to paragraphs
(2) and (3) shall not be considered funds for distribution to local
educational agencies.
(B) Not less than two hundred thousand dollars ($200,000) of the
amount subject to subparagraph (A) shall be made available for
proportionate awards to applicant education centers pursuant to
Article 6 (commencing with Section 33380) of Chapter 3 of Part 20 of
the Education Code, for tobacco use prevention projects.
(2) Not less than two hundred thousand dollars ($200,000) of the
amount awarded pursuant to Section 104420 shall be used for the
support of statewide program evaluation.
(3) Not more than nine hundred thousand dollars ($900,000) of the
amount awarded pursuant to Section 104420 shall be awarded as grants
for technical assistance, implementation strategies, and regional
coordinating activities related to tobacco use prevention pursuant to
subdivision (l) of Section 104420.
(b) Any amount that exceeds the amounts specified in subdivision
(a) shall be allocated for competitive grants pursuant to subdivision
(l) of Section 104420.
(c) On and after January 1, 1992, funding to which this section
applies shall be made available only upon a determination by the
Legislative Analyst and the Tobacco Education Oversight Committee, in
the evaluation required by subdivision (c) of Section 104375,
indicating that the tobacco use prevention program meets the purpose
of this article.
104435. County offices of education that receive funds pursuant to
subdivision (l) of Section 104420 shall do all of the following:
(a) Provide technical assistance and training to school districts
and consortia of school districts regarding planning and preparation
of antitobacco programs plans pursuant to State Department of
Education guidelines.
(b) Provide for appropriate coordination between school districts
programs and local antitobacco use programs funded by the local lead
agency.
(c) Participate in the review and scoring of applications
submitted by school districts for grant awards made pursuant to
Section 104420.
(d) Participate in the monitoring and technical assistance review
process for school districts and county offices of education pursuant
to Section 104455.
104440. Local lead agencies shall be ineligible for awards under
the competitive grants program, unless the local lead agency is
participant within a consortium of community-based organizations or
nonprofit organizations.
104445. In awarding grants under the competitive grants program,
the department shall give preference to all of the following:
(a) Nonprofit or community-based organizations.
(b) Current contractors that meet both of the following
requirements:
(1) Have demonstrated effectiveness and capacity in providing
tobacco education services.
(2) Serve populations and areas with substantial unmet service
needs.
(c) Proposals that provide new or expanded services to geographic
areas or target populations underserved, as determined by the
department.
104450. (a) The State Department of Education shall develop a
common reporting format for districts receiving
tobacco-use-prevention funds under this article.
(b) The format required by subdivision (a) shall be designed to
provide annual data on all of the following:
(1) Tobacco-use-prevention education program expenditures.
(2) Tobacco-use-prevention education program instructional and
other services to targeted and general student populations.
(3) Tobacco-use-prevention education program staff development and
parent training.
(4) Other information determined to be appropriate by the
department.
(c) The information provided by the format required by subdivision
(a) shall be in a quantitative format that describes the number of
individuals who are served and the number of individuals receiving
each type of service.
(d) In addition to the requirements of subdivision (c), the
information to be provided by the format required by subdivision (a)
shall include, at a minimum, all of the following:
(1) (A) The number of students receiving tobacco-use-prevention
instruction and the type of curriculum used.
(B) The format required by subdivision (a) shall show, by
category, those students listed for the purpose of subparagraph (A),
in each target group listed in Section 104360.
(2) Other programmatic activities directly targeted to students,
and the number of students participating in each.
(3) The types of staff development or other tobacco-use-prevention
training and, by staff classification, the number of staff members
receiving the training.
(4) The number of parents receiving training and the types of
training provided.
(5) The types of programs geared toward community involvement and
the number of people served by each type.
(6) The types of services provided to target populations that are
in addition to services provided to other students.
(7) The number and size of schools that are tobacco-free.
(8) The ways in which money appropriated for the purpose of this
article has been spent, including the following categories: salaries,
including, but limited to, personnel, and substitute teacher costs;
benefits; travel; consultant services; operating expenses, including,
but not limited to, curriculum and instructional materials,
supplies, other; capital outlay; and indirect costs.
(e) (1) Each county office of education shall provide to the State
Department of Education an annual report on district expenditures
and services within its respective county pursuant to the common
reporting format developed by the State Department of Education.
(2) The county shall provide an annual report of the information
required in paragraph (8) of subdivision (d).
104455. The State Department of Education shall monitor and ensure
implementation of district and county offices of education
tobacco-free policies and tobacco-use prevention education programs
in districts receiving funding from the Cigarette and Tobacco
Products Surtax Fund through procedures determined by the
Superintendent of Public Instruction after consultations with the
committee.
104460. (a) Each school district receiving funds from the Cigarette
and Tobacco Products Surtax Fund shall make all of the following
services available to every pregnant minor and minor parent enrolled
in the school district:
(1) Referral to perinatal and related support services.
(2) Outreach services and assessment of smoking status.
(3) Individualized counseling and advocacy services.
(4) Motivational messages.
(5) Cessation services, if appropriate.
(6) Incentives to maintain a healthy lifestyle.
(7) Followup assessment.
(8) Maintenance and relapse prevention services.
(b) Where appropriate, those services listed in subdivision (a)
shall be integrated with existing programs for pregnant minors and
minor parents.
(c) Each district plan submitted in application for funds under
this article shall include a description of the availability of the
services required by this section.
104465. (a) The department may annually set aside three million
dollars ($3,000,000) appropriated for the purposes of the competitive
grants program established pursuant to this article in order to
support efforts to link the statewide media campaign to local
communities and to provide regional public and community relations or
media initiatives.
(b) Local community initiatives may include, but are not limited
to, all of the following:
(1) Encouraging volunteer efforts.
(2) Local media programming.
(3) Provision of assistance in, and facilitation of, public and
community events.
(c) The efforts described in subdivision (b) shall be directed
principally to the target communities described in Section 104360.
(d) Regular application procedures for competitive grants under
this article shall apply to applications for grants under this
section.
(e) Funds awarded pursuant to this section shall be awarded in the
same manner as other competitive grants under this article.
104466. Notwithstanding subdivision (a) of Section 2.00 of the
Budget Act of 2002 and any other provision of law, commencing with
the appropriation for the 2002-03 fiscal year, and for each fiscal
year thereafter, any amount appropriated to the department to
implement the following tobacco use prevention programs shall be
available for encumbrance and expenditure for three fiscal years
beyond the date of the appropriation:
(a) The program to evaluate tobacco control programs provided for
in subdivisions (b) and (c) of Section 104375.
(b) The tobacco use prevention media campaign provided for in
subdivision (e) of Section 104375.
(c) The competitive grant program provided for in Section 104385.
(d) The local lead agency tobacco use prevention programs provided
for in Section 104400.
(e) The tobacco use prevention program directed at schools
provided for in Sections 104420, 104425, 104430, and 104435.
104470. The State Department of Education shall make periodic
reports to the committee regarding the status and funding of tobacco
education programs funded under this article as required by the
committee. The reports shall include an overview of program and grant
expenditures funded under this article.
104475. There is hereby created under the authority of the
Controller the Tobacco Education Fund.
104480. All guidelines, criteria, standards, and requirements
specified in this article are exempt from the requirements of Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code, and shall be implemented without being
adopted as regulations.
104495. (a) For the purposes of this section, the following
definitions shall govern:
(1) "Playground" means any park or recreational area specifically
designed to be used by children that has play equipment installed, or
any similar facility located on public or private school grounds, or
on city, county, or state park grounds.
(2) "Tot lot sandbox area" means a designated play area within a
public park for the use by children under five years of age. Where
the area is not contained by a fence, the boundary of a tot lot
sandbox area shall be defined by the edge of the resilient surface of
safety material, such as concrete or wood, or any other material
surrounding the tot lot sandbox area.
(3) "Public park" includes a park operated by a public agency.
(4) "Smoke or smoking" means the carrying of a lighted pipe,
lighted cigar, or lighted cigarette of any kind, or the lighting of a
pipe, cigar, or cigarette of any kind, including, but not limited
to, tobacco, or any other weed or plant.
(5) "Cigarette" means the same as defined in Section 104556.
(6) "Cigar" means the same as defined in Section 104550.
(b) No person shall smoke a cigarette, cigar, or other
tobacco-related product within 25 feet of any playground or tot lot
sandbox area.
(c) No person shall dispose of cigarette butts, cigar butts, or
any other tobacco-related waste within 25 feet of a playground or a
tot lot sandbox area.
(d) No person shall intimidate, threaten any reprisal, or effect
any reprisal, for the purpose of retaliating against another person
who seeks to attain compliance with this section.
(e) Any person who violates this section is guilty of an
infraction and shall be punished by a fine of two hundred fifty
dollars ($250) for each violation of this section. Punishment under
this section shall not preclude punishment pursuant to Section 13002,
Section 374.4 of the Penal Code, or any other provision of law
proscribing the act of littering.
(f) The prohibitions contained in subdivisions (b), (c), and (d)
shall not apply to private property.
(g) The prohibitions contained in subdivisions (b) and (c) shall
not apply to a public sidewalk located within 25 feet of a playground
or a tot lot sandbox area.
(h) This section shall not preempt the authority of any county,
city, or city and county to regulate smoking around playgrounds or
tot lot sandbox areas. Any county, city, or city and county may
enforce any ordinance adopted prior to January 1, 2002, or may adopt
and enforce new regulations that are more restrictive than this
section, on and after January 1, 2002.
