BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1395
                                                                  Page  1

          Date of Hearing:  June 28, 2010

                        ASSEMBLY COMMITTEE ON TRANSPORTATION
                               Bonnie Lowenthal, Chair
                    SB 1395 (Alquist) - As Amended:  June 14, 2010

           SENATE VOTE  :  35-0
           
          SUBJECT  :  Organ donation

           SUMMARY  :  Requires driver's license applicants to indicate  
          whether or not they choose to be organ donors.  Specifically,  
           this bill  :  

          1)Makes findings and declarations regarding the need for organ  
            donors and the intent of the Legislature to establish an  
            Altruistic Living Donor Registry (Altruistic Registry).  

          2)Authorizes California organ procurement organizations to  
            establish a not-for-profit entity designated as the Altruistic  
            Living Donor Registrar (Altruistic Registrar), which would  
            establish and maintain an Altruistic Registry.  

          3)Requires the Altruistic Registry to contain information  
            regarding persons who have identified themselves as altruistic  
            living kidney donors and to be designed to promote and assist  
            live kidney donations, including paired exchanges and  
            nondirected donations.  

          4)Makes the Altruistic Registrar responsible for developing  
            methods to increase the number of donors who enroll in the  
            Altruistic Registry and requires him or her to make available  
            to the federally designated organ procurement organizations  
            and transplant centers in California information contained in  
            the Registry regarding potential altruistic living donors.  

          5)Requires this information to be used to expedite a match  
            between identified organ donors and potential recipients.  

          6)Allows the Altruistic Registrar to receive voluntary  
            contributions to support the Altruistic Registry and its  
            activities.  

          7)Requires the Altruistic Registrar to collect and make  
            specified information relating to altruistic kidney donations  








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            available to the public.  

          8)Allows the Altruistic Registrar to authorize the Altruistic  
            Registry to include persons who identify themselves as  
            altruistic living donors of organs and tissue other than  
            kidneys to be added to the Registry, upon a finding by the  
            Registrar that the donation is generally regarded as safe and  
            without a significant risk of complications, and would not  
            adversely affect the health of the donor. Upon making such a  
            finding, the Registrar would be required to notify the  
            appropriate policy committees of the Legislature.  

          9)Requires, on and after July 1, 2011, an application for a new  
            or renewal driver's license or identification (ID) card to  
            contain a space for the applicant to enroll in the Donate Life  
            California Organ and Tissue Donor Registry (Donor Registry).  
          10)  Requires the application to include check boxes for an  
            applicant to mark either, "Yes, add my name to the donor  
            registry," or "I do not wish to register at this time."  

          11)  Requires the Department of Motor Vehicle (DMV) to inquire  
            verbally of an applicant applying in person for an original or  
            renewal driver's license or ID card at a DMV office as to  
            whether the applicant wishes to enroll in the Donate Life  
            California Organ and Tissue Donor Registry.  Failure or  
            refusal to answer this question or check a box on the  
            application form would not constitute a basis for DMV to deny  
            an applicant a driver's license or ID card.  

          12)  Requires the driver's license and ID card applications to  
            include the statement: "Marking 'Yes' adds your name to the  
            Donate Life California Organ and Tissue Donor Registry and a  
            pink 'donor' dot will appear on your license.  If you wish to  
            remove your name from the registry you must contact Donate  
            Life California (see back); DMV can remove the pink dot from  
            your licenses but cannot remove you from the registry."  

          13)  Requires the backs of the applications to contain the  
            statement: "If, on the front of this form, you marked 'Yes' to  
            register as an organ and tissue donor you are legally  
            authorizing the recovery of organs and tissues in the event of  
            your death.  Registering as a donor will not affect your  
            medical treatment in any way.  As outlined in the California  
            Anatomical Gift Act, your authorization is legally binding  
            and, unless the donor is under 18 years of age, your decision  








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            does not require the consent of any other person.  For  
            registered donors under 18 years of age, the legal guardian  
            shall make the final donation decision.  You may limit your  
            donation to organs or tissues, place usage restrictions, for  
            example transplantation or research, obtain more information  
            about donation, or remove your name from the registry on the  
            Internet Web site of Donate Life California:  
             www.donateLIFEcalifornia.org  ."  

          14)  Requires DMV to transmit to the Donor Registry and the  
            appropriate policy and fiscal committees of the Legislature an  
            annual report, and to make available quarterly updates,  
            detailing funds collected through voluntary contributions as  
            well as a summary of applicants, including date and method of  
            application, donor registration status, zip code, gender, and  
            year of birth.  

          15)  Provides that the requirement for submitting the annual  
            report is inoperative four years after the date the first  
            annual report is due.  

           EXISTING LAW  :

          1)Requires the front of an application for an original or  
            renewal of a driver's license or ID card to contain a space  
            for an applicant to give his or her consent to be an organ and  
            tissue donor upon death.  

          2)Requires an applicant who gives consent to be directed to read  
            a statement on the back of the application that contains  
            specified information regarding organ donation.  

          3)Requires DMV to collect donor designation information on all  
            applications for an original or renewal driver's license or ID  
            card.  

          4)Requires DMV to print the word "DONOR" or another appropriate  
            designation on the face of a driver's license or ID card to a  
            person who registered as a donor.  

          5)Requires DMV, on a weekly basis, to electronically transmit to  
            Donate Life California specified information on every  
            applicant who has indicated his or her willingness to  
            participate in the organ donation program.  









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          6)Allows driver's license and ID card applicants to designate a  
            voluntary contribution of $2 to Donate Life California to be  
            collected by DMV for the purpose of promoting and supporting  
            organ and tissue donation.  

          7)Requires the donor enrollment form to be posted on the  
            Internet Web sites for DMV and the California Health and Human  
            Services Agency.  

           FISCAL EFFECT  :  Unknown.  This bill was withdrawn from the  
          Senate Appropriations Committee pursuant to Senate Rule 28.8.  

           COMMENTS  :  Currently over 21,000 California residents are  
          waiting for organ transplants.  It is estimated that one-third  
          of these people will die before they are able to receive the  
          donations that they need.  Of those, over 17,000 are waiting for  
          a kidney transplant, and the waiting list continues to grow.  

          This bill's sponsor, Governor Arnold Schwarzenegger, states:   
          "Organ donation is one of the kindest, most generous and  
          powerful actions that each and every one of us can take.  With  
          thousands of people in California and throughout the nation  
          currently waiting for a transplant, this legislation represents  
          a new and important resource to increase donor rates.  I am  
          excited to partner with the legislature to implement this  
          life-saving legislation and make California a leader in organ  
          donations."  

          A major portion of this bill deals with the establishment of an  
          Altruistic Living Donor Registry to facilitate the donation of  
          kidneys from living donors.  These provisions have no  
          transportation implications.  The balance of the bill affects  
          DMV in that it alters the process of applying for a new or  
          renewal driver's license or ID card so that an applicant must  
          either enroll with the Donor Registry or decline to enroll.  If  
          an applicant fails to check the Yes or No box, the DMV clerk  
          would be required to prompt the applicant to indicate his or her  
          choice.  The author asserts that this change will increase the  
          chances that a person will add him or herself to the Donor  
          Registry.  

          The bill further requires that DMV report annually, as well as  
          provide quarterly updates, on the funds collected through  
          voluntary contributions as well as a summary of information  
          about applicants who consent to be organ donors.  With this  








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          information, the organ donation community will know better the  
          revenues it will receive and will be able to improve its donor  
          outreach efforts.  

          SB 108 (Speier), Chapter 740, Statutes of 2001 authorized the  
          establishment of a Donor Registry in the California Health and  
          Human Services Agency.  The Agency never received funding for  
          the registry, and in 2003, SB 112 (Speier), Chapter 405,  
          transferred responsibility for establishing the registry to a  
          private, nonprofit organization administered by the four  
          federally-designated organ procurement organizations.  

          SB 112 (Speier), Chapter 405, Statutes of 2003, built on a  
          provision of then-current law that required DMV to provide donor  
          registration forms to those applying for drivers' licenses or ID  
          cards.  These forms included instructions to mail the completed  
          form to Donate Life California. Donate Life California found  
          this system an ineffective method of signing up donors, and  
          therefore sponsored SB 689 (Speier), Chapter 665, Statutes of  
          2005, which requires DMV to collect organ and tissue donor  
          designation information on its applications for drivers'  
          licenses and ID cards.  Donate Life reports that about 25  
          percent of those applying or renewing a driver's license or ID  
          card sign up to be donors.  This bill is a further attempt to  
          increase that percentage.  

          Although DMV continues to struggle with wait times for its  
          customers, it is unlikely that the added burden of requiring its  
          clerks to pose to license applicant's follow-up questions on  
          organ donations will have a significant impact on processing  
          times and it may, in fact, ultimately result in saving  
          additional lives.  

           Author's amendment:   Under this bill, the Altruistic Registrar  
          would be authorized to allow the Altruistic Registry to expand  
          to include individuals who designate themselves as altruistic  
          living donors of organs and tissue other than kidneys if the  
          Altruistic Registrar finds that these types of donations are  
          generally safe, without significant risk of complications, and  
          would not adversely affect the health of the donor.  The author  
          agreed in the prior committee to amend the bill to require such  
          a determination to be made upon a finding by the federal Centers  
          for Medicare and Medicaid and the United Network for Organ  
          Sharing, rather than the registrar.  The agreed-to amendment is  
          as follows:  On page 4, line 23, delete "registrar" and insert  








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          "Centers for Medicare and Medicaid (CMS) and the United Network  
          for Organ Sharing (UNOS)"  

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          Governor Arnold Schwarzenegger (sponsor)
          American Federation of State, County and Municipal Employees
          California Academy of Physician Assistants
          California Hospital Association
          California Medical Association
          Community Health Partnership
          DaVita Dialysis 
          Donate Life California
          El Camino Hospital
          National Kidney Foundation
          Santa Clara County 
          Stanford Hospital and Clinics

           Opposition 
           
          None on file

          
          Analysis Prepared by  :   Howard Posner / TRANS. / (916) 319-2093