BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1297
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 1297 (John A. Pérez)
          As Amended August 19, 2013
          Majority vote
           
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          |ASSEMBLY:  |75-0 |(May 9, 2013)   |SENATE: |37-0 |(August 22,    |
          |           |     |                |        |     |2013)          |
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           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  








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          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  








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          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 


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