BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 52
                                                                  Page  1

          Date of Hearing:   April 22, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                   AB 52 (Portantino) - As Amended:  April 1, 2009 

          Policy Committee:                              HealthVote:14-2

          Urgency:     Yes                  State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill extends and significantly expands the Umbilical Cord  
          Blood Collection Program (UCBCP) established by AB 34  
          (Portantino), Chapter 516, Statutes of 2007. Specifically, this  
          bill: 

          1)Extends the implementation date of UCBCP from January 1, 2010  
            to January 1, 2011.

          2)Increases the fee charged for a certified copy of a birth  
            certificate from $7 to $9 until 2020. Requires the additional  
            fee revenue to be deposited in a special fund established by  
            AB 34. 

          3)Requires the Department of Public Health (DPH) to contract  
            with up to five licensed or accredited blood banks to build a  
            diverse inventory of cord blood, store the cord blood, and  
            make it available for medical transplantation or medical  
            research. 

          4)Requires the UCBCP to meet numerous objectives, including the  
            establishment of a public awareness campaign, a public health  
            emergency program, collection targets for specified ethnic  
            groups, and an increase in hospital participation. 

          5)Establishes a 15-member Committee to implement new UCBCP  
            activities established in this bill. Requires the Committee to  
            make recommendations by January 1, 2012 to the governor and  
            Legislature. Requires DPH and the Committee to submit reports  
            on the Program's effectiveness to the Assembly and Senate  
            Health and Judiciary Committees and the governor by January 1,  
            2013 and January 1, 2018.








                                                                  AB 52
                                                                  Page  2


          6)Requires participating blood banks to comply with federal  
            requirements associated with the National Cord Blood  
            Inventory. 

           FISCAL EFFECT  

          1)Increased annual special fund revenues of $3 million as a  
            result of a $2 increased fee on 1.5 million certified birth  
            certificates until 2020. Revenues will change with changes in  
            California's birth rate or demand for the vital records  
            documents. Fee revenues will support the activities of  
            contracted blood banks. Private blood banks currently charge  
            $1,000 to $2,000 in one-time collection fees and $50 to $150  
            in annual storage fees. Public blood banks do not charge  
            collection and storage fees on cord blood available for public  
            use. 

          2)Certified birth certificates are required for acquisition of  
            personal documents such as a Social Security cards for  
            newborns and for other personal documents for adults, such as  
            passports. There are 550,000 births in California annually.  
            The other million certified birth certificates subject to the  
            fee increase established in this bill are for children and  
            adults requiring additional vital records documentation.  

          3)Annual DPH fee-supported special fund staffing costs of  
            $550,000 to $650,000 for contract management, research and  
            policy collaboration, and technical assistance. 

           COMMENTS  

           1)Rationale  .  This bill is sponsored by the American College of  
            Obstetricians and Gynecologists (ACOG). As a continued effort  
            by the author and ACOG, this bill increases the availability  
            of cord blood and the ethnic diversity of the supply of cord  
            blood to better reflect the diverse genetic needs of  
            California families. Umbilical cord blood collection is a  
            relatively recent phenomenon and the cord blood available  
            publicly does not reflect the racial diversity of California.  
            Thousands of patients with blood diseases such as leukemia,  
            myeloma, lymphoma, and sickle cell anemia die each year after  
            failing to find matching stem cells that are found in very  
            high concentrations in cord blood. By increasing the  
            likelihood and frequency of cord blood matches, this bill will  








                                                                  AB 52
                                                                  Page  3

            eventually reduce illness and death associated with these  
            kinds of diseases.  

           2)Background  . Stem cells provide a mechanism by which organisms,  
            including humans, are able to renew themselves through cell  
            regeneration and differentiation. The three categories of  
            mammalian stem cells are: embryonic stem cells, adult stem  
            cells, and cord blood stem cells. Stem cells can be easily  
            grown and transformed into specialized cells such as muscles  
            or nerves. Umbilical cord blood is of particular interest due  
            to the ease of collection and the low risk of collection and  
            treatment. Compared to bone marrow collection, cord blood  
            collection is non-invasive, painless, inexpensive, and  
            relatively simple. In addition, cord blood matching requires a  
            less close match than is required with adult stem cells. 

           3)The National Cord Blood Inventory  (NCBI) was established  
            pursuant to the Stem Cell Therapeutic and Research Act of  
            2005, Public Law 109-129. As a part of the Act, the NCBI has a  
            goal of collection of 150,000 units of cord blood. One  
            California blood bank is a part of NCBI collection efforts. In  
            addition to federal efforts started by the prior  
            administration with regard to cord blood, the President  
            recently overturned a policy signed by President Bush in 2001  
            that prohibited the National Institutes of Health from  
            supporting research on embryonic stem cells beyond the 60 cell  
            lines that existed at that time.  

          Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081