BILL ANALYSIS Ó
AB 2399
Page 1
Date of Hearing: April 13, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
AB
2399 (Nazarian) - As Amended March 28, 2016
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill extends the umbilical cord collection program and
contains related provisions. Specifically, this bill:
AB 2399
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1)Extends the state umbilical cord collection program for an
additional five years, from January 1, 2018 to January 1,
2023.
2)Extends a $2 fee on certified copies of birth certificates to
support the program.
3)Requires the California Department of Public Health (CDPH) to
publish informational materials regarding umbilical cord blood
storage, prenatal testing, and prenatal human immunodeficiency
virus (HIV) in multiple languages.
4)Repeals existing law making the implementation of a community
awareness campaign about umbilical cord blood donation by CDPH
contingent upon receiving sufficient private donations,
thereby making the requirement operative.
FISCAL EFFECT:
1)The state would continue to incur costs to the Health
Statistics Special Fund and collect about $2.5 million
annually in revenues to support the state umbilical cord
collection program through calendar year 2022. The program is
currently administered by UC Davis Health System through
contract with CDPH.
2)Uncertain, significant costs to conduct a public awareness
campaign. The costs would depend on the robustness of the
effort, and could easily be millions of dollars ongoing for an
effective statewide campaign (GF). The current statute
requires the campaign provide awareness, assistance, and
information regarding umbilical cord blood banking options
using brochures, television, print media, radio, Internet Web
AB 2399
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sites, outdoor advertising, and other media.
3)Costs to CDPH of approximately $30,000 to translate the
prenatal information into the additional languages (Genetic
Disease Fund).
COMMENTS:
1)Purpose. According to the author, studies have shown cord
blood is a rich source of stem cells that can be used to treat
various diseases and disorders. The author believes this is a
worthy program that should be extended, and that proposed
changes will increase outreach and awareness, thereby
increasing the diversity of cord blood collected by the
program and available for California's diverse population.
2)Uses of Cord Blood. Donated cord blood can be banked for use
in transplants. It has been used to treat certain diseases of
the blood and immune system, as well as inherited diseases (of
red blood cells, the immune system and certain metabolic
abnormalities). Cells from cord blood also demonstrate the
potential to help conditions that have no cure today by
regenerating damaged tissue and restoring lost function after
an injury or illness. Cord blood can be donated to a public
bank or can be privately banked for personal use, though
private banking is generally not recommended unless there is a
family history of specific genetic diseases.
AB 2399
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3)Cord Blood Collection Program. The program whose sunset is
extended by this bill was created by AB 52 (Portantino),
Chapter 529, Statutes of 2010, and is funded through an
additional $2 fee on birth certificate copies. It is a
statewide public program designed to capture the genetic
diversity of Californians through the collection of cord
blood. The program does not administer a public cord blood
bank, but sets up collection sites in hospitals and
facilitates the relationship between a hospital and public
bank. The program attempts to make a hospital's participation
in the program cost-neutral by providing contract staff or
reimbursing hospitals for their staffing costs, as well as
managing the administrative aspects of the collection. Once
collected, the blood is stored at a public bank, such as San
Diego Blood Bank. Banks register each unit of collected cord
blood under the National Marrow Donor Program, which maintains
a global registry of available cord blood units.
The collection program targets hospitals that are ethnically
diverse, in order to increase the chances that a donor can be
found for persons of ethnic heritage that are not currently
well-represented among cord blood donors. Banks attempt to
match proteins called Human Leukocyte Antigen (HLA), and a
person's HLA typing is related to ethnicity. A match between
a donor's and a patient's HLA markers is essential for a
successful transplant outcome.
4)Staff Comments. The relationship between birth certificates
and cord blood donation appears limited to the fact that they
both relate to the birth of a child. In addition, it is
unclear what the appropriate ongoing expenditure level is for
a program of this type. If this program model is the best way
to ensure a diversity of samples is available for the benefit
of California's population, the author may wish to consider
whether there are alternative funding sources for this program
and ensure there is a match between program needs and
revenues.
AB 2399
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Additionally, while some level of public awareness effort
appears to be warranted, the nature of cord blood collection
at the time of birth suggests that public education has to be
a sustained, ongoing effort to educate new mothers and that
targeted approaches may be more cost-effective than large
statewide media campaigns.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081