BILL ANALYSIS
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THIRD READING
Bill No: AJR 13
Author: Ammiano (D)
Amended: 08/25/09 in Assembly
Vote: 21
SENATE HEALTH COMMITTEE : 5-0, 6/9/10
AYES: Alquist, Cedillo, Leno, Negrete McLeod, Pavley
NO VOTE RECORDED: Strickland, Aanestad, Cox, Romero
ASSEMBLY FLOOR : 46-29, 9/8/09 - See last page for vote
SUBJECT : Blood donation
SOURCE : Equality California
DIGEST : This resolution requests the President of the
United States to encourage, and the Secretary of the United
States Department of Health and Human Services to adopt,
policies that repeal the current donor suitability and
deferral policies of the Food and Drug Administration (FDA)
regarding blood donation by men who have had sex with other
men and, instead, direct the FDA to develop science-based
policies.
ANALYSIS : Existing federal law establishes the FDA which
regulates the collection of blood and blood components used
for transfusion or for the manufacture of pharmaceuticals
derived from blood and blood components.
Pursuant to federal guidelines regarding blood donation,
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the FDA:
1. Requires potential donors to be asked screening
questions about their health status, health behaviors,
and other factors associated with an increased risk of
being infected with transmissible disease, in order to
help persons identify themselves as potentially at
higher risk for transmitting infectious diseases and
defer from donating on their own accord, rather than
unknowingly donating blood that may be infected.
2. Requires that the minimum information presented to
potential donors at every visit indicate clearly that
persons meeting certain criteria should not donate
blood, including, but not limited to, men who have had
sex with other men even one time since 1977.
3. Prohibits blood donation establishments from allowing
men who have had sex with other men even one time since
1977 to donate blood, even when such a donor does not
wish to self-defer.
Existing state law
1. Prohibits blood or blood components from being used for
humans in this state, unless the blood or blood
components have been tested and found nonreactive for
HIV, with specified exceptions.
2. Requires that blood banks and plasma centers make
laboratory tests of all human whole blood and blood
components received to detect the presence of viral
hepatitis and HIV in the manner specified. If the blood
bank or plasma center finds the presence of viral
hepatitis, or an antigen thereof, in the blood or blood
components tested, it shall report that finding to the
local health officer.
3. Pursuant to the Unruh Civil Rights Act, provides that
all persons within the jurisdiction of this state are
free and equal, and specifically prohibits
discrimination based on sex, race, color, religion,
ancestry, national origin, disability, medical
condition, marital status, or sexual orientation with
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respect to accommodations, advantages, facilities,
privileges, or services in all business establishments
of every kind.
This resolution requests the President and the Department
of Health and Human Services to adopt science-based
policies that repeal current Food and Drug Administration
policies that prohibit men who have had sex with men from
donating blood.
Background
FDA guidelines . In the U.S., there are over twenty million
transfusions of blood, red cell concentrates, plasma or
platelets every year. The FDA is responsible for ensuring
and enhancing blood safety and to protect blood recipients.
As biological products, blood and blood products are
likely always to carry an inherent risk of infectious
agents. Therefore, zero risk may be unattainable. The role
of FDA is to drive that risk to the lowest level reasonably
achievable without unduly decreasing the availability of
this life saving resource.
Over a period of years, the FDA has attempted to strengthen
safeguards to protect patients from unsuitable blood and
blood products. Blood donations are tested for seven
different infectious agents. Blood donors are now asked
specific and direct questions about risk factors that could
indicate possible infection with a transmissible disease.
This "up-front" screening eliminates approximately 90
percent of unsuitable donors. FDA also requires blood
centers to maintain lists of unsuitable donors to prevent
the use of collections from them.
Men who have had sex with other men (MSM), at any time
since 1977 (the beginning of the AIDS epidemic in the
United States) are currently deferred as blood donors.
This is because the FDA believes that MSM are, as a group,
at increased risk for HIV, hepatitis B and certain other
infections that can be transmitted by transfusion. The
FDA's policy regarding men who have had sex with men was
first imposed in 1983 in response to the AIDS crisis, when
little was known about the disease or how it is spread.
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The agency claims its MSM deferral policy is intended to
protect all people who receive blood transfusions from an
increased risk of exposure to blood potentially infected
with certain disease-causing agents, including HIV. The
FDA has stated it would change its MSM deferral policy
"only if supported by scientific data showing that a change
in policy would not present a significant and preventable
risk to blood recipients."
The deferral for men who have had sex with men is based on
several considerations regarding risk of HIV. Data from
the Centers for Disease Control and Prevention (CDC) show
that HIV and other blood-borne pathogens are not randomly
distributed in the population, but are concentrated within
specific subgroups. Surveillance data from the CDC indicate
that men who have sex with men and would be likely to
donate have a HIV prevalence that is over 15 fold higher
than the general population, and over 2,000 fold higher
than current repeat blood donors (i.e., those who have been
negatively screened and tested) in the U.S. Male-to-Male
sexual contact continues to account for the highest amount
of new HIV cases (53 percent) followed by high-risk
heterosexual contact (31 percent).
FISCAL EFFECT : Fiscal Com.: No
SUPPORT : (Verified 6/10/10)
Equality California (source)
AIDS Legal Referral Panel
Blood Centers of California
California Communities United Institute
Center for AIDS Research, Education and Services
City of West Hollywood
Gay Straight Alliance Network
National Center for Lesbian Rights
Sacramento Cares
Santa Clara Board of Supervisors
Santa Clara County Board of Supervisors
Southern California HIV Advocacy Coalition
Stonewall Democratic Club of Sacramento
University of San Francisco School of Law - Pride Law
Association
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OPPOSITION : (Verified 6/10/10)
Capitol Resource Family Impact
Concerned Women for America
ARGUMENTS IN SUPPORT : The City of West Hollywood
supports this bill because they believe the FDA's policy
prevents innumerable gay and bisexual men who are otherwise
healthy from contributing to the nation's blood supply.
They claim that several colleges and universities around
the country no longer sponsor on-campus blood drives,
claiming that the FDA's policy runs counter to their
anti-discrimination rules. Given that a significant number
of HIV cases are via heterosexual contact, the rationale
for this 1983 ban is irrational and highly biased.
Blood Centers of California supports the policy of the AAB,
ABC, and ARC, which advocate that the deferral period for
male-to-male sex be changed to 12 months. BCC's primary
concern is maintaining an adequate and safe blood supply
for California based on volunteer donors. With the aging
of the established blood donor population, BCC believes
that we must continuously encourage and recruit a younger
generation to fulfill this vital role of volunteering.
ARGUMENTS IN OPPOSITION : Concerned Women of California
claims that this resolution creates an unnecessary threat
to the health and safety of our nation. They quote the
FDA, citing that scientific models show there is a small
but definite increased risk to people who receive blood
transfusions if the FDA's MSM policy is changed and that
preventable transfusion transmission of HIV could occur as
a result. They claim that less than three percent of the
population accounts for nearly half of the HIV cases, and
that statistic should cause the greatest possible caution
in protecting the blood supply and the public health.
Capitol Resource Family Impact claims that the FDA's
policies are not discriminatory, and that they also prevent
donations from those who use intravenous drugs or have been
paid for sexual intercourse. They claim the FDA has
admitted that although testing has improved, it cannot
detect 100 percent of HIV-infected blood. These measures
protect innocent recipients who could survive a
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life-threatening accident only to face life with an
incurable disease.
ASSEMBLY FLOOR :
AYES: Ammiano, Arambula, Beall, Block, Blumenfield,
Brownley, Buchanan, Chesbro, Coto, Davis, De La Torre, De
Leon, Eng, Evans, Feuer, Fong, Fuentes, Furutani,
Galgiani, Hall, Hayashi, Hernandez, Hill, Huber, Huffman,
Jones, Krekorian, Lieu, Bonnie Lowenthal, Ma, Mendoza,
Monning, Nava, John A. Perez, Portantino, Ruskin, Salas,
Saldana, Skinner, Solorio, Swanson, Torlakson, Torres,
Torrico, Yamada, Bass
NOES: Adams, Anderson, Bill Berryhill, Tom Berryhill,
Blakeslee, Conway, Cook, DeVore, Duvall, Emmerson,
Fletcher, Fuller, Gaines, Garrick, Gilmore, Hagman,
Harkey, Jeffries, Knight, Logue, Miller, Nestande,
Niello, Nielsen, Silva, Smyth, Audra Strickland, Tran,
Villines
NO VOTE RECORDED: Caballero, Charles Calderon, Carter, V.
Manuel Perez, Vacancy
CTW:do 6/10/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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