BILL ANALYSIS                                                                                                                                                                                                    



                                                                AB 995
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        CONCURRENCE IN SENATE AMENDMENTS
        AB 995 (Block)
        As Amended July 23, 2009
        Majority vote
         
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        |ASSEMBLY:  |     |(May 28, 2009)  |SENATE: |38-0 |(August 27,    |
        |           |     |                |        |     |2009)          |
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              (vote not relevant)


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        |COMMITTEE VOTE:  |17-0 |(September 2, 2009) |RECOMMENDATION: |Concur    |
        |                 |     |                    |                |          |
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        Original Committee Reference:    HEALTH  

         SUMMARY  :  Exempts from tissue bank licensing requirements a  
        licensed physician or podiatrist storing a human cell, tissue, or  
        cellular- or tissue-based medical device or biologic product, as  
        specified.  

         The Senate amendments  delete the Assembly version of this bill, and  
        instead: 

        1)Exempt from state "tissue bank" licensing requirements the  
          storage of a human cell, tissue, or cellular- or tissue-based  
          medical device or biologic product that is approved by the  
          federal government, as specified, by a licensed physician or  
          podiatrist acting within his or her scope of practice, and in a  
          lawful setting, if the product was obtained from a California  
          licensed tissue bank and stored as directed by the manufacturer,  
          for use by the physician or podiatrist on his or her own patient.  


        2)Require the entity or organization where the physician or  
          podiatrist practices to notify the Department of Public Health  
          (DPH) of the following:  the practitioner is licensed and working  
          within the scope and authority of his or her license and practice  
          for the purpose of direct patient care; a list of practitioners  
          to whom the notification applies; agreement of each listed  
          practitioner to strictly abide by the manufacturer's directions  
          for storage and other instructions and guidelines; and,  








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          acknowledgement that the product will not be resold or  
          distributed. 

         EXISTING LAW  defines a tissue bank as any place, establishment, or  
        institution that collects, processes, stores, or distributes tissue  
        for transplantation into human beings, and requires tissue banks to  
        be licensed by DPH, unless specifically exempted.  Current  
        exemptions include storage of freeze-dried dermis by a dentist and  
        storage of freeze-dried bone by a dentist or general acute care  
        hospital.

         AS PASSED BY THE ASSEMBLY  , this bill deleted requirements that DPH  
        establish regulations governing tissue banks, and instead required  
        tissue banks to comply with the current standards of the American  
        Association of Tissue Banks, required DPH to evaluate and consider  
        for adoption future amendments to the AATB standards pursuant to a  
        prescribed process, and changed the civil administrative penalties  
        DPH may impose for noncompliance with the standards.

         FISCAL EFFECT  :  According to the Senate Appropriations Committee,  
        pursuant to Senate Rule 28.8, negligible state costs.

         COMMENTS  :  DPH recently began interpreting tissue bank laws to  
        require podiatrists and physicians to register as tissue banks if  
        they store tissue products for more than 24 hours, even if the  
        tissue product is intended solely for the practitioner's own  
        patient.  According to the author, requiring licensed health care  
        practitioners who lawfully obtain products from a California  
        licensed tissue bank to also be licensed as tissue banks could  
        jeopardize access to bioactive devices and products.  The author  
        states the purpose of this bill is to continue to allow licensed  
        physicians and podiatrists to use and store tissue products to  
        treat patients without being licensed as tissue banks.  

        The author states that newly developed bioactive devices and  
        products deliver living, cell-based products to stimulate the  
        body's own healing process, and are approved by the federal Food  
        and Drug Administration (FDA) to treat painful diabetic foot ulcers  
        and venous leg ulcers, which are the most frequently occurring  
        chronic wounds.  According to the author, physicians and  
        podiatrists must obtain bioactive devices and products from  
        licensed tissue banks and store and use them according to  
        manufacturer directions, which are regulated by FDA.  

        The California Podiatric Medical Association (CPMA), co-sponsor of  








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        this bill, writes that diabetic ulcers and other chronic wounds can  
        lead to significant pain, diminished quality of life, impaired  
        mobility, reduced productivity, and even amputations and death.   
        CPMA asserts that when conventional wound care fails, bioengineered  
        tissue products can sometimes be used to assist the body's natural  
        healing process.  Such bioactive devices are often administered in  
        small clinical settings, such as a physician's or podiatrist's  
        office.  Advanced BioHealing, Inc., also a co-sponsor of this bill,  
        state that under current practice, there have been no significant  
        negative events.  Another co-sponsor, Organogenesis, Inc., states  
        advanced biologic products are subject to strict premarket approval  
        and post-approval requirements over the manufacturing process,  
        shipping method and container, storage requirements, expiration  
        dates, and instructions for use and storage.  

        This bill was substantially amended in the Senate and the  
        Assembly-approved provisions of this bill were deleted.  This bill,  
        as amended in the Senate, is inconsistent with Assembly actions.


         Analysis Prepared by  :    Allegra Kim / HEALTH / (916) 319-2097 


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