BILL ANALYSIS
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Date of Hearing: March 23, 2010
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
ACR 74 (Portantino and Hill) - As Amended: February 24, 2010
SUBJECT : Umbilical cord blood banking.
SUMMARY : States that the Legislature desires to find ways to
help California gain a viable public umbilical cord blood
banking system to ensure that all races and ethnicities have an
equal probability of finding a match when medically necessary.
Specifically, this resolution :
1)Makes a number of legislative findings and declarations
related to the public and private umbilical cord blood
collection industry as a treatment for blood cancers and other
diseases, the lack of public knowledge about the differences
of the public and private umbilical cord blood banking
systems, the lack of genetic diversity of public umbilical
cord blood inventories, the importance of using umbilical cord
blood that is not suitable for transplantation for research
institutions to explore the potential of umbilical cord blood
stem cells to treat medical conditions, and the importance of
building a viable public banking system.
2)States the Legislature's desire to find ways to help
California gain a viable public umbilical cord blood banking
system to ensure that all races and ethnicities have an equal
probability of finding a match when medically necessary.
3)States the Legislature's support for research being done with
collected units that are not suitable for transplantation.
EXISTING FEDERAL LAW :
1)Establishes a national umbilical cord blood network and
authorizes funding to collect and maintain human cord blood
stem cells for the treatment of patients and for research.
2)Includes a process for maternal donors to be informed of all
medically appropriate options for cord blood banking and
includes additional directives for cord blood donation,
education, and advocacy.
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EXISTING STATE LAW :
1)Requires the California Department of Public Health (DPH) to
establish, by January 1, 2010, and until January 1, 2015, the
Umbilical Cord Blood Collection Program (UCBCP) for the
purpose of collecting and storing umbilical cord blood and
increasing the amount of umbilical cord blood that is donated
in the state and added to the National Cord Blood Inventory
(NCBI).
2)Authorizes the UCBCP, to the extent private or public funds
are identified and secured for these purposes, to contract
with blood banks that are licensed or accredited to provide
umbilical cord blood banking storage services, for the purpose
of collecting and storing umbilical cord blood for public
transplantation services. Permits DPH to implement any
additional standards for blood banks to collect and store
umbilical cord blood through the adoption of regulations.
3)Requires DPH, contingent upon private funding, to conduct the
Umbilical Blood Community Awareness Campaign to provide
awareness and information regarding umbilical cord blood
banking options using print media, radio, the Internet,
outdoor advertising and other media, to establish an Internet
Web site, and to undertake public education activities related
to umbilical cord blood donation to targeted populations, as
appropriate.
FISCAL EFFECT : None
COMMENTS :
1)PURPOSE OF THIS RESOLUTION . According to the author, most
cord blood is collected for private usage and although this
service is a great benefit to individuals, it does not ensure
the general public has access to this potential treatment for
a variety of medical conditions. The author believes that
this resolution will help increase awareness for the need to
create a public cord blood banking system that will bring the
benefits of this resource to a broad and more diverse group of
Californians.
2)UMBILICAL CORD BLOOD . According to information from the
National Marrow Donor Program (NMDP), cord blood, which is the
blood collected from the umbilical cord and placenta after a
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baby is born, is rich in blood-forming cells that can be used
in transplants for patients with leukemia, lymphoma, and many
other life-threatening diseases. Cord blood is one of three
sources of cells used in transplants; the other two are bone
marrow and peripheral blood stem cells. The NMDP estimates
that, on any given day, more than 6,000 patients around the
world are searching the NMDP's registry for a matching bone
marrow or cord blood donor. Since cord blood is stored and
ready to use and it does not require a perfect donor match,
the NMDP states that it is especially useful for patients who
need a transplant quickly, patients who have difficulty
finding a matched bone marrow donor, and patients from
racially diverse communities who often have uncommon tissue
types. Patients are more likely to match someone who shares
their racial and ethnic heritage. The NMDP reports that, in
2008, 36% of the 90,000 cord blood units in its registry went
to patients from racially or ethnically diverse communities
and the need for cord blood donations from these populations
remains high.
In January 2007, the American Academy of Pediatrics (AAP) issued
an updated policy statement on cord blood banking for
potential future transplantation. The AAP estimates that the
chances of a child needing his or her own cord blood stem
cells in the future range from one in 1,000 to one in 200,000.
In the event that a child requires a stem cell transplant,
the AAP indicates that it is unlikely that the child's own
cord blood would be the desired source of stem cells because
the cells would reintroduce the disease into the child's body.
In these cases, a sibling donor is ideal and usually still
alive and available as a donor so banked blood is not needed.
AAP states that storing a child's cord blood is only
worthwhile when there is a sibling with a disease that can be
treated by a transplant. Under these circumstances there is a
one-in-four chance that the new baby will be a match for his
or her sibling. Given that the probability of using one's own
cord blood in the first 20 years of life is very small, the
AAP does not favor storage of cord blood for personal use and
encourages families to donate their newborn's cord blood to
public banks, if accessible in their area, for use by other
individuals in need.
3)PUBLIC AND PRIVATE CORD BLOOD BANKS . Public and private banks
provide for the collection and storage of cord blood. Public
banks promote related and unrelated donation, similar to the
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current collection of whole blood units in the U.S., for
transplantation or research purposes. Private banks store
cord blood from an individual for subsequent use by the same
individual or his or her family members should the need arise.
Private banks typically charge between $1,000 and $2,000 in
collection fees and between $50 and $125 annually for storage.
Public banks do not charge for cord blood that is donated for
public use. The American Association of Blood Banks (AABB)
and the Foundation for the Accreditation of Cellular Therapy
(FACT) provide voluntary accreditation of cord blood banks
using standards governing all aspects of operation, including
collection, processing, and transplantation. According to
their respective Web sites, 25 facilities nationwide are
currently accredited by the AABB and eight currently have FACT
accreditation.
4)CALIFORNIA BANKS . According to the NMDP, there are currently
two participating public banks in California, StemCyte
International Cord Blood Center in West Covina, which provides
both public and private banking services, and Children's
Hospital of Orange County Cord Blood Bank. Another public
bank in San Diego, the Ashley Ross Cord Blood Program,
participates in the NMDP, but it is not actively collecting
cord blood at this time due to funding shortages. According
to the nonprofit Parent's Guide to Cord Blood Foundation,
there are currently four private banks operating in the state:
CordBancUSA in Monterey, Cord Blood America and FamilyCord,
both based in Los Angeles, and Cord Blood Registry in San
Bruno.
5)NATIONAL CORD BLOOD INVENTORY . The NCBI, administered by the
federal Health Resources and Services Administration (HRSA),
was formed in 2006 to build a genetically and ethnically
diverse inventory of 150,000 new units of high-quality
umbilical cord blood for transplantation and make these cord
blood units available to physicians and patients for blood
stem cell transplants, and for research focusing on cord blood
stem cell biology and the use of cord blood for human
transplantation and cellular therapies. The NCBI works to
achieve these goals by providing funds to reimburse a network
of eight participating cord blood banks nationwide for the
collection and storage of qualified cord blood units. HRSA
has requested nearly $12 million in funding for the NCBI in
2009 to add approximately 8,650 new units of cord blood, for a
total of approximately 37,280 units collected to date.
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6)UCBCP . AB 34 (Portantino), Chapter 516, Statutes of 2007,
creates the UCBCP for the purpose of collecting and storing
umbilical cord blood. The UCBCP is permitted to contract with
licensed and accredited blood banks to provide cord blood
storage services, to the extent that public or private funds
or grants are available and creates a special fund for
donations and grants. According to DPH, it has not received
public or private funds or grants to establish the UCBCP and
has not received notice from the Department of Finance that
any funds were deposited into the UCBCP Fund. However, DPH
did report receiving a one-year grant of $471,240 from HRSA in
September 2009 to collect, process, and store cord blood from
minority populations in order diversify the national inventory
of umbilical cord blood stem cell units that are available for
transplantation. This appropriation is currently awaiting
authorization through the budget process.
7)RELATED LEGISLATION . AB 52 (Portantino), introduced in 2009,
extends for one year the date which DPH is required to
establish the UBCBP from January 1, 2011, until January 1,
2020, for the purpose of collecting and storing umbilical cord
blood for public use. Additionally the bill would require DPH
to establish the California Umbilical Cord Collection Board
that would administer the program, and would require the
collection of a $9 fee for certified copies of birth
certificates, $2 of the fee would be paid to the Umbilical
Cord Blood Collection Program Fund. AB 52 is currently in
Senate Health Committee.
8)PREVIOUS LEGISLATION :
a) AB 34 (Portantino) directs DPH to establish the UCBCP by
January 1, 2010, until January 1, 2015, for the purpose of
collecting and storing umbilical cord blood, permits the
UCBCP, to the extent public or private funds or grants are
identified, to contract with blood banks that are licensed
and accredited to provide cord blood storage services, and
creates a special fund for donations and grants to UCBCP.
b) SB 962 (Migden), Chapter 517, Statutes of 2007, requires
DPH to provide umbilical cord blood samples to the Birth
Defect Monitoring Program, for storage and research, as
specified.
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c) SB 1555 (Speier), Chapter 484, Statutes of 2006,
requires blood banks, in order to provide umbilical cord
blood banking storage services, to be licensed and requires
DPH, contingent upon private funding, to conduct the
Umbilical Blood Community Awareness Campaign.
REGISTERED SUPPORT / OPPOSITION :
Support
American Congress of Obstetricians & Gynecologists, District
IX/California (sponsor)
Blood Centers of California
California Catholic Conference
University of California
Opposition
None on file.
Analysis Prepared by : Martin Radosevich / HEALTH / (916)
319-2097