BILL ANALYSIS
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|SENATE RULES COMMITTEE | ACR 74|
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THIRD READING
Bill No: ACR 74
Author: Portantino (D), et al
Amended: 8/16/10 in Senate
Vote: 21
SENATE HEALTH COMMITTEE : 8-0, 6/16/10
AYES: Alquist, Strickland, Aanestad, Cedillo, Leno,
Negrete McLeod, Pavley, Romero
NO VOTE RECORDED: Cox
ASSEMBLY FLOOR : Read and adopted, 3/23/10
SUBJECT : Umbilical cord blood banking
SOURCE : Chord Blood Registry
American Congress of Obstetricians and
Gynecologists,
District IX
DIGEST : This resolution makes a number of legislative
findings and declarations related to public and private
umbilical cord blood collection as a means of providing
treatment for blood cancers and other diseases, and 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.
Senate Floor Amendments of 8/16/10 remove language that
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states some medical organizations' recommendation against
umbilical cord blood banking for future family use and
instead states that, to date, most transplants for
malignant or genetic disease have been provided by public
banks from another individual, although stem cells from a
matched sibling have been especially suitable.
ANALYSIS : 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.
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.
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.
3.Permits DPH to implement any additional standards for
blood banks to collect and store umbilical cord blood
through the adoption of regulations.
4.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
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Internet, outdoor advertising and other media, to
establish an Internet website, and to undertake public
education activities related to umbilical cord blood
donation to targeted populations, as appropriate.
This resolution:
1.Makes a number of legislative findings and declarations
related to:
A. The history of umbilical cord blood transplants,
research and treatment;
B. Public and private umbilical cord blood collection
industry as a treatment for blood cancers and other
diseases;
C. The lack of public knowledge about the differences
of the public and private umbilical cord blood banking
systems;
D. The lack of genetic diversity of public umbilical
cord blood inventories;
E. 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,
F. The importance of building a viable public banking
system.
2.States that consumers are informed that banking their
families' umbilical cord blood may be clinically useful
for their future medical needs, but should be aware that
to date, most transplants have been provided by public
banks because a patient's malignant or genetic disease
was most effectively treated by stem cells from another
individual, although stem cells from a matched sibling
have been especially suitable.
3.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.
4.States the Legislature's support for research being done
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with collected units that are not suitable for
transplantation.
Background
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 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 percent 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 1 in 1,000 to 1
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
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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.
Comments
AB 34 (Portantino), Chapter 516, Statutes of 2007, creates
the California 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 to 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.
FISCAL EFFECT : Fiscal Com.: No
SUPPORT : (Verified 8/17/10)
Chord Blood Registry (source)
American Congress of Obstetricians and Gynecologists,
District IX (source)
Association of Northern California Oncologists
Bay Bio
Blood Centers of California
California Academy of Physician Assistants
California Chronic Care Coalition
California Catholic Conference
National Bone Marrow Program
University of California
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ARGUMENTS IN SUPPORT : The American Congress of
Obstetricians and Gynecologists, District IX, California
states that a general public awareness of what cord blood
is, what it can do, and a nonbiased explanation of the
differences between private and public cord blood banking,
brings clarity and support to umbilical cord blood banking.
The University of California (UC) states that increasing
umbilical cord banking for public use, such as for
transplant or for research, is an important policy goal
that the University is familiar with and supports. UC
notes that the UCLA campus was selected by the National
Institutes of Health, as one of two sites, to build a
national cord blood bank system in the late 1990s, which
was shut down in April, 2001 due to funding limitations.
UC contends that ACR 74 highlights the financial challenges
faced by public umbilical cord blood banks.
CTW:nl 8/17/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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