BILL ANALYSIS Ó AB 1297 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 1297 (John A. Pérez) As Amended August 19, 2013 Majority vote ----------------------------------------------------------------- |ASSEMBLY: |75-0 |(May 9, 2013) |SENATE: |37-0 |(August 22, | | | | | | |2013) | ----------------------------------------------------------------- Original Committee Reference: HEALTH SUMMARY : Facilitates the sharing of information between coroners and organ procurement organizations (OPOs) regarding cases in which an anatomical gift may be available from a person whose demise is imminent and that person's body will be subject to a death investigation by the coroner post mortem. The Senate amendments clarify that health care providers, health care service plans, and contractors are required to disclose certain medical information, if compelled by a coroner, upon being notified of an imminent death that may involve organ or tissue donation and make other technical and clarifying changes. EXISTING LAW : 1)Establishes the Uniform Anatomical Gift Act (UAGA) to govern organ and tissue donation in California and specify who may make an anatomical gift, how to document a gift or refusal, how to amend or revoke a gift, to whom a gift may be made, and delivery of a gift. 2)Requires a coroner or medical examiner (ME) to assist in implementation of the UAGA; cooperate with OPOs to maximize the opportunity to recover anatomical gifts for the purpose of transplantation, therapy, research, or education; permit the authorized and lawful removal and timely disposition of donated organs and tissue from the bodies of deceased persons; ensure anatomical gifts do not interfere with an autopsy or investigation; and, enter into agreements with OPOs to coordinate gift recovery procedures within that coroner's or ME's jurisdiction or in cooperation with other coroners or MEs throughout the state. FISCAL EFFECT : According to the Senate Appropriations AB 1297 Page 2 Committee, pursuant to Senate Rule 28.8, negligible state costs. COMMENTS : According to the author, OPOs are often made aware of cases where individuals have agreed upon their death to make an anatomical gift. The author maintains that UAGA authorizes OPOs to discuss information related to an anatomical gift, but state law does not clearly allow coroners to discuss information with OPOs about those individuals who are on life support and who have agreed to make an anatomical gift. The author states that this bill is intended to allow this information to be shared in order to facilitate the ability of the coroner to conduct a post mortem examination or investigation in a manner and timeframe compatible with the body or part's preservation for purposes of the gift. The author points out that time is of the essence when it comes to organ transplants and when a donated organ is not recovered in a timely manner, such as within four to six hours for a heart or lung and between 12-24 hours for a liver or pancreas, its chances of surviving long enough to serve a needy patient diminish. A county coroner or ME plays an important role in the organ and tissue donation process. Since all unexpected deaths require coroner or ME review, their cooperation and support is vital for ensuring successful organ and tissue donations to benefit thousands of transplant recipients each year. OPOs collaborate with coroners or MEs in the referral and evaluation of potential organ and tissue donors to broaden the donation options for donor families, while preserving evidence for death investigations to determine the cause and manner of death. OPOs usually have a coroner liaison to work closely with and serve as a dedicated resource regarding donation with coroners and MEs. After the OPO staff determines organ and tissue recovery will take place, the coroner or ME is notified and clearance is obtained for transplantation to occur in accordance with UAGA. Currently, consultation between coroners or MEs and OPOs takes place after a potential donor has died. However, in cases where OPOs communicate information to coroners or MEs about the gift wishes of a donor who is on life support prior to death, coroners or MEs are currently prevented from doing anything more than taking the information. This bill seeks to formalize the communication between coroners or MEs and OPOs in cases where a person who wishes to donate is facing imminent death and his or her body after death would be subject to a death investigation by the coroner or ME, such as a person who has been taken off AB 1297 Page 3 life support, in order to facilitate timely recovery of the donated organs. The sponsor of this bill, Donate Life California (DLC), writes in support that, in unique cases where individuals have expressed their intent to donate, but they do not technically fall under a coroner's jurisdiction yet, such as persons on life support who have not yet died, there is a very narrow time window between declaration of death and the commencement of organ recovery by OPOs. DLC states that these circumstances require the OPO to consult with the coroner or ME prior to declaration of death since the body is deemed likely to fall under the coroner's jurisdiction post mortem. According to DLC, by formally addressing the relationship between OPOs and coroners in these particular instances, this bill would enshrine in statute and make uniform a practice that is currently occurring to ensure all interested parties are able to perform their responsibilities and honor the donor's wish to save lives after he or she dies. The California State Coroners' Association adds in support that this bill sets up a process between OPOs and coroners or MEs in these particular cases to ensure that the donor's wish to save lives after his or her death can be honored. Analysis Prepared by : Lara Flynn / HEALTH / (916) 319-2097 FN: 0001875