BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 1419
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|AUTHOR: |Galgiani |
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|VERSION: |February 19, 2016 |
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|HEARING DATE: |April 6, 2016 | | |
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|CONSULTANT: |Reyes Diaz |
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SUBJECT : Uniform Anatomical Gift Act: prison inmates
SUMMARY : Requires the Department of Corrections and Rehabilitation
(CDCR) to develop a form, as specified, allowing a prisoner to
elect to make an anatomical gift in the event of his or her
death. Requires CDCR to present the form to the prisoner, as
specified, as well as to allow the prisoner to revoke his or her
election to make an anatomical gift, as specified.
Existing law: Establishes the Uniform Anatomical Gift Act, which
regulates the making and distribution of organ donations.
This bill:
1)Requires CDCR to develop and adopt a form that allows a
prisoner to elect to make an anatomical gift in the event of
his or her death. Requires the form to be included in the
prisoner's central file.
2)Requires the form to be titled "Document of Gift-Donate Life
California Organ and Tissue Donor Registry" and to have at a
minimum the following characteristics:
a) Clearly indicate the prisoner's election to be
added to the donor registry;
b) Contain a statement notifying the prisoner
that by signing or placing his or her mark on the form
that the prisoner is legally authorizing the recovery
of organs or tissues in the event of his or her death;
and,
c) Contains the prisoner's signature or mark if
the prisoner cannot write.
3)Requires the form to be presented to the prisoner upon his or
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her first admittance into the state prison system. Allows the
prisoner to elect to sign the form or refuse to sign at that
time.
4)Requires the form to be made available for completion and
signature at the prisoner's request, consistent with the
policies and procedures of CDCR.
5)Allows the prisoner to revoke his or her election to make an
anatomical gift at any time by delivery of a written statement
to the official in charge of the facility where the prisoner
is confined. Requires CDCR, upon receipt of this statement, to
mark the form described in 2) above as revoked. Requires CDCR
to retain the revoked document of gift and the statement
revoking the gift in the prisoner's central file.
FISCAL
EFFECT : This bill has not been analyzed by a fiscal committee.
COMMENTS :
1)Author's statement. According to the author, the United States
is currently facing a shortage of anatomical gift donors, with
California making up 20% of the national donor waiting list.
Additionally, less than one percent of hospital deaths meet
the criteria for organ donation. It is estimated that one
individual organ donor can save the lives of up to eight
people, and tissue donors can help more than 50 people. Due to
the fact that there is no process in place to provide inmates
with the chance to donate, potential donors are prevented from
registering. This bill will create a voluntary process for an
inmate to register as an organ donor, which could increase the
donor pool. It is important to note that this bill also
requires a process to be in place for the inmate to remove
him- or herself from registration at any time. In Utah, where
similar legislation allowing for voluntary sign up has been
enacted, more than 250 inmates have already signed up to be
donors.
2)Background. The Organ Procurement and Transplantation Network
(OPTN) is a public-private partnership that links all
professionals involved in the United States donation and
transplantation system. The United Network for Organ Sharing
(UNOS) serves as the OPTN under contract with the Health
Resources and Services Administration of the U.S. Department
of Health and Human Services. Currently, every transplant
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hospital program and organ procurement organization in the
U.S. is an OPTN member. Membership means that their transplant
programs are certified by UNOS and that they play an active
role in forming the policies that govern the transplant
community. In California, there are 21 transplant centers
(hospitals) and four organ procurement organizations (OPOs),
which are authorized by the Centers for Medicare and Medicaid
Services to procure organs for transplantation. Each
individual hospital comes up with their own policies to
evaluate patients and determine eligibility to receive an
organ transplant. UNOS develops the policies to determine how
available organs are distributed among eligible patients
waiting for a transplant. According to Donate Life
California's Web site, there are currently more than 123,000
people in the U.S. waiting for a life-saving organ transplant,
and nearly 22,000 live in California. Every 10 minutes another
person is added to the waiting list.
3)CDCR inmate screening. According to CDCR, inmates are screened
at intake by a nurse to identify any physical and mental
health care needs. The inmate is tested for tuberculosis and
hepatitis C, and, if requested, for HIV. Within 14 days of
entering CDCR's custody, all inmates undergo a comprehensive
medical evaluation in which a physician obtains a medical
history from the inmate. Any information obtained during the
medical evaluation is self-disclosed by the inmate, as CDCR
does not have access to any prior medical records. Any process
involving informed consent is required to be done by a
physician during the comprehensive medical evaluation. CDCR
does not solicit an inmate's interest in being an organ and
tissue donor. Inmates are responsible for disclosing whether
they are already registered as organ and tissue donors during
the medical evaluation, and that information is noted in the
medical record.
CDCR provides an Advance Directive for Health Care to an inmate
if it is requested specifically by the inmate or the inmate's
medical condition warrants it because the inmate is facing a
life-threatening condition or treatment. This document
consists of a durable power of attorney, which allows inmates
to designate someone to make decisions on their behalf if they
are unable to do it on their own, and a living will, which
allows inmates to state their goals or desires for the types
of health care they do or do not want. The advance directive
form includes an optional section for an inmate to choose
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whether or not he or she is willing to donate organs or other
tissues upon death. If an inmate chooses to complete this part
of the form, the inmate is instructed to check the box that
applies to the inmate's wish. The inmate may give any needed
organs or tissues, may specify which organs and tissues he or
she wants to donate, or may select the box choosing not to
donate. The inmate may also designate whether his or her gift
is for purposes of transplantation, therapy, research, or
education. Before an inmate signs the advance directive, a
medical staff person is required to document that the inmate
has been fully informed and understands the form, and two
additional witnesses are required to verify that the inmate
has willingly signed the form and completed it according to
the inmate's wishes.
4)Double referral. Should this bill pass out of this Committee,
it will be referred to the Senate Committee on Public Safety.
5)Prior legislation. SB 1395 (Alquist, Chapter 217, Statutes of
2010), authorized the establishment of a living donor registry
to sign up kidney donors and required the Department of Motor
Vehicles to include on an application for an original or
renewal driver's license or identification card specified
language asking the applicant if he or she wants to enroll
with the Donate Life California Organ and Tissue Donor
Registry and giving the applicant information about the
registry, including disenrollment information.
AB 2440 (Berryhill, of 2010), would have required prison
inmates to complete an organ and tissue donor consent form
upon admittance to a state prison. AB 2440 failed passage in
the Assembly Health Committee.
AB 289 (Plescia, of 2003), would have, among other things,
allowed an organ donor to prohibit his or her organs from
being donated to prison inmates. AB 289 was never heard in the
Assembly Health Committee.
6)Policy comment. This bill requires the organ donation form to
be presented to a prisoner upon first admittance. While CDCR
states that at intake prisoners are screened for physical and
mental health care needs, it is unclear whether the screening
would occur before or after the organ donation form is
presented to the inmate. This raises the question of whether a
prisoner who is determined to need mental health care needs is
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capable of consenting to organ donation.
SUPPORT AND OPPOSITION :
Support: None received
Oppose: None received
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