BILL ANALYSIS
AB 1487
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 1487 (Hill)
As Amended August 10, 2010
2/3 vote. Urgency
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|ASSEMBLY: | |(May 18, 2009) |SENATE: |31-0 |(August 12, |
| | | | | |2010) |
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(vote not relevant)
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|COMMITTEE VOTE: |18-0 |(August 24, 2010) |RECOMMENDATION: |concur |
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Original Committee Reference: PUB. S.
SUMMARY : Extends, to January 1, 2014, the date by which the
Department of Public Health (DPH) is required to adopt regulations
prescribing sperm processing facilities' handling and storage of
sperm from donors who are carriers of human immunodeficiency virus
(HIV) and human T lymphotrophic virus (HTLV), and requires a
physician providing insemination and advanced reproductive
technologies (ART) to make specified disclosures to a recipient of
sperm from a HIV or HTLV reactive spouse, partner, or designated
donor.
The Senate amendments delete the Assembly version of this bill, and
instead:
1)Require the testing of transplant donor tissue for infection with
HTLV only in tissues that are rich in viable leukocytes.
2)Require a physician providing ART to notify the recipient of
sperm from a HIV or HTLV reactive spouse, partner, or designated
donor of all of the following:
a) Sperm processing may not eliminate all of the risks of HIV
or HTLV transmission;
b) The sperm may be tested to determine whether or not it is
reactive for HIV or HTLV;
AB 1487
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c) The recipient must document prior to treatment that she has
a physician to provide ongoing care during and after her
fertility services; and,
d) Information about recommendations published by the American
Society of Reproductive Medicine (ASRM) regarding follow-up
testing for HIV and HTLV, and a requirement that the
recommendations regarding follow-up testing will be documented
in the recipient's medical record.
3)Clarify that a physician providing ART is not responsible for
prophylactic testing, monitoring, and follow-up of the recipient.
Require the physician to recommend follow-up testing for HIV or
HTLV, according to ASRM's published guidelines, to the physician
who will be providing the recipient's ongoing care, as specified.
4)Require, in the event the recipient becomes HIV or HTLV positive,
the physician assuming ongoing care of the recipient to treat or
provide information regarding referral to a physician who can
provide ongoing treatment for HIV or HTLV.
5)Extend the date by which DPH is required to adopt regulations
prescribing sperm processing facilities' handling and storage of
sperm from donors who are carriers of HIV, HTLV, or any other
virus DPH deems appropriate from January 1, 2010, to January 1,
2014.
6)Permit DPH to propose to adopt, as initial regulations, specified
recommendations published by the ASRM using a specified process.
7)Exempt adoption of regulations for sperm processing facilities
from requirements for written responses to public comments and
the Administrative Procedure Act.
8)Make other minor technical clarifying changes and add an urgency
clause to make the provisions of this bill take effect
immediately upon enactment.
AS PASSED BY THE ASSEMBLY , this bill increased from $3 to $6 the
fee charged for each inmate-initiated medical visit by an inmate
confined in a county or city jail.
FISCAL EFFECT : According to the Senate Appropriations Committee,
pursuant to Senate Rule 28.8, negligible state costs.
AB 1487
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COMMENTS : According to the author, HIV is now considered a chronic
disease, and many HIV-infected adults have near normal life
expectancy with typical life goals such as starting a family. The
author states that due to advances in reproductive technologies,
sperm washing can separate healthy sperm from the other components
in semen that may contain HIV, removing 99.9% of HIV particles, so
HIV- and HTLV-infected sperm can be used in ART with virtually no
risk of transmission to mother and baby. Over 4,500 assisted
reproduction procedures are documented in the literature with no
reports of HIV transmission when using standardized sperm washing
methods with either intrauterine insemination or in-vitro
fertilization. SB 443 (Migden), Chapter 207, Statutes of 2007, was
intended to ensure access to reproductive treatment for
HIV-discordant couples (HIV-positive male and HIV-negative female).
However, the author states SB 443 was unclear about which medical
professionals were responsible for the care of the infected sperm
donor and for follow-up of the recipient, and included some medical
terminology that was inaccurate or insufficiently inclusive. Also,
sperm infected with different types of HTLV, not just HTLV-I, can
be safely used once processed, so this bill uses the broader
language. The author argues this bill is needed to fix those
problems.
The processing of sperm from a donor testing reactive for HIV or
HTLV is commonly referred to as sperm washing. Numerous studies
have confirmed that HIV is primarily found in white blood cells and
plasma in semen, not generally within the sperm itself. The sperm
washing process involves centrifuging the semen in order to
separate it from the sperm. This process can also involve a
"swim-up" technique that removes inactive sperm. The remaining
active sperm can then be used for insemination or ART. Numerous
studies report that the sperm-washing process reduces HIV levels in
sperm, and the technology and procedures continue to improve.
Analysis Prepared by : Cassie Rafanan / HEALTH / (916) 319-2097
FN: 0006742