BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 52
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          ASSEMBLY THIRD READING
          AB 52 (Portantino)
          As Amended June 2, 2009
          2/3 vote. Urgency 

           HEALTH              14-2        APPROPRIATIONS      13-2        
           
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          |Ayes:|Jones, Ammiano, Block,    |Ayes:|De Leon, Nielsen,         |
          |     |Carter,     De La Torre,  |     |Ammiano,                  |
          |     |De Leon, Emmerson, Hall,  |     |Charles Calderon, Davis,  |
          |     |Hayashi, Hernandez,       |     |Fuentes, Hall, John A.    |
          |     | Bonnie Lowenthal, Nava,  |     |Perez, Price, Skinner,    |
          |     |              V. Manuel   |     |Solorio, Torlakson,       |
          |     |Perez, Salas              |     |Krekorian                 |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Gaines, Audra Strickland  |Nays:|Duvall, Audra Strickland  |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Extends for one year the date by which the Department  
          of Public Health (DPH) is required to establish the Umbilical  
          Cord Blood Collection Program (UCBCP); and, requires DPH to  
          contract with up to five licensed or accredited blood banks to  
          collect and store umbilical cord blood, as specified.  Imposes a  
          temporary $1 fee on specified birth certificates to fund the  
          program.  Contains an urgency clause to ensure that the  
          provisions of this bill go into immediate effect upon enactment.  
           Specifically,  this bill  :  

          1)Extends from January 1, 2010, to January 1, 2011, the date by  
            which DPH is required to establish the UCBCP.

          2)Requires DPH to contract with up to five entities, including  
            entities that are licensed or accredited to provide umbilical  
            cord blood collection and data processing, and entities that  
            are licensed or accredited to provide cord blood banking  
            storage services, to build an inventory of anonymous umbilical  
            cord blood units and make the inventory available for  
            transplant or medical research.  Permits DPH to use a  
            competitive process to identify qualified entities.

          3)Requires entities selected pursuant to 2) above to have  
            experience in blood collection, labeling, storage,  








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            transportation, and distribution.  Requires DPH to endeavor to  
            select entities with demonstrated ability to retrieve  
            umbilical cord blood from ethnically diverse communities.

          4)Requires DPH to ensure that any cord blood bank receiving  
            funds through the UCBCP complies with existing federal  
            requirements to ensure that all cord blood units collected can  
            be listed through the National Cord Blood Inventory (NCBI).

          5)Requires a medical provider or research facility to comply  
            with, and be subject to existing penalties for violations, of  
            all state and federal laws governing the protection of medical  
            information and any personally identifiable information  
            contained in the umbilical cord blood inventory.

          6)Requires DPH to make every effort to avoid duplication or  
            conflicts with existing and ongoing programs and to leverage  
            existing resources and use its existing authority to promote  
            the collection, storage, and use of umbilical cord blood and  
            advise the Legislature of its needs to accomplish these goals.

          7)Requires information collected pursuant to the UCBCP to be  
            confidential and used solely for the program.  Limits access  
            to confidential information to authorized persons who agree,  
            in writing, to maintain confidentiality.

          8)Makes any person who violates a written confidentiality  
            agreement or who uses confidential information in an  
            unauthorized manner subject to a maximum civil penalty of  
            $1,000, as specified.

          9)Specifies that an individual to whom the confidential  
            information pertains shall have access to his or her own  
            personal information. 

          10)Increases the fee for a certified copy of a birth certificate  
            from $7 to $8; and, requires the additional $1 to be deposited  
            in the existing UCBCP Fund.

          11)Sunsets the provisions of this bill on January 1, 2015. 

           EXISTING LAW  : 

          1)Requires DPH to establish the UCBCP by January 1, 2010, and  








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            until January 1, 2015, for the purpose of increasing the  
            amount of umbilical cord blood that is donated in the state  
            and added to the NCBI.  

          2)Authorizes the UCBCP, to the extent private or public funds  
            are identified and secured for these purposes, to identify and  
            provide funds for grants or contracts with qualified blood  
            banks that are licensed and accredited to collect and store  
            umbilical cord blood for public transplantation services.   
            Permits DPH to implement any additional standards for blood  
            banks to collect and store umbilical cord blood through the  
            adoption of regulations. 

          3)Requires DPH, contingent upon private funding, to conduct the  
            Umbilical Cord Blood Community Awareness Campaign to provide  
            awareness, assistance, and information regarding umbilical  
            cord blood banking options using brochures, television, print  
            media, radio, the Internet, outdoor advertising, and other  
            media; establish an Internet Web site with specified  
            information; and, undertake public education activities  
            related to umbilical cord blood donation to targeted  
            populations, as appropriate.

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)Increased annual special fund revenues and expenditures of  
            $1.5 million as a result of a $1 increased fee on 1.5 million  
            certified birth certificates each year until 2015.  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)Unknown DPH fee supported special fund staffing costs to  
            support the requirements of this bill.  Recent amendments  
            narrow the scope of DPH requirements substantially.

           COMMENTS  :  The author states that the NCBI currently lacks  
          ethnic and multiracial cord blood and the UCBCP is intended to  
          collect cord blood for public use and increase the volume of  








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          cord blood that can be added to the national inventory.   
          According to the author, this bill prescribes important  
          requirements relating to donor confidentiality protections, an  
          implementing committee, minimum program standards, reporting  
          requirements, and a temporary $2 funding mechanism, that are  
          needed to fully implement the UCBCP.  The author believes this  
          bill will ensure that collections from California's ethnically  
          diverse communities will help to address shortages in cord blood  
          donations from minority groups and increase the likelihood of  
          transplant patients finding suitable donor matches.

          According to information from the National Marrow Donor Program  
          (NMDP), cord blood refers to the blood collected from the  
          umbilical cord and placenta after a baby is born.  Cord blood is  
          one of three sources of cells used in transplants; the other two  
          are bone marrow and peripheral blood stem cells.  The NMDP  
          estimates that, on any given day, more than 6,000 patients  
          around the world are searching the NMDP's registry for a  
          matching bone marrow or cord blood donor.  Patients are more  
          likely to match someone who shares their racial and ethnic  
          heritage.  The NMDP reports that in 2008, 36% of the 90,000 cord  
          blood units in its registry went to patients from racially or  
          ethnically diverse communities and the need for cord blood  
          donations from these populations remains high. 

          Public and private banks provide for the collection and storage  
          of cord blood.  Public banks promote related and unrelated  
          donation, similar to the current collection of whole blood units  
          in the United States., for transplantation or research purposes.  
           Private banks store cord blood from an individual for  
          subsequent use by the same individual or his or her family  
          members should the need arise.  Private banks typically charge  
          between $1,000 and $2,000 in collection fees and between $50 and  
          $150 annually for storage.  Public banks do not charge for cord  
          blood that is donated for public use.  According to the NMDP,  
          there are currently two participating public banks in  
          California:  StemCyte International Cord Blood Center in West  
          Covina, which provides both public and private banking services;  
          and, Children's Hospital of Orange County Cord Blood Bank.   
          According to the nonprofit Parent's Guide to Cord Blood  
          Foundation, there are currently four private banks operating in  
          the state:  CordBancUSA in Monterey; Cord Blood America and  
          FamilyCord, both based in Los Angeles; and, Cord Blood Registry  
          in San Bruno.








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          The sponsor of this bill, the American College of Obstetricians  
          and Gynecologists, asserts that this bill builds on the  
          highly-supported UCBCP to increase public banking of cord blood.  
           The Blood Centers of California point out that the continuing  
          lack of multi-ethnic cord blood donations is a pressing issue  
          for many patients in need of transplants and this bill will help  
          to increase the supply of cord blood units to ensure more  
          compatible matches are available.  The California Medical  
          Association adds that this bill aims to improve collection of a  
          genetically diverse cord blood supply that mirrors California's  
          population for public use.  Lastly, the American Federation of  
          State, County and Municipal Employees states that it is  
          important to utilize this valuable resource for the benefit of  
          persons with certain blood deficiencies and genetic diseases.  


           Analysis Prepared by  :    Cassie Rafanan / HEALTH / (916)  
          319-2097 

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