BILL ANALYSIS
SENATE TRANSPORTATION & HOUSING COMMITTEE BILL NO: SB 1395
SENATOR ALAN LOWENTHAL, CHAIRMAN AUTHOR: alquist
VERSION: 4/5/10
Analysis by: Carrie Cornwell FISCAL: yes
Hearing date: April 13, 2010
SUBJECT:
Organ and tissue donation
DESCRIPTION:
This bill requires that a person applying for or renewing a
California Driver's License or identification card indicate
whether or not he or she will be an organ donor, and it also
authorizes creation of a living donor registry to sign up kidney
donors.
ANALYSIS:
Existing law authorizes California's federally-designated organ
procurement organizations (OPOs) to establish a not-for-profit
organization to be designated the California Organ and Tissue
Donation Registrar (registrar). The OPOs established Donate Life
California as the registrar, and Donate Life California
established and maintains the California Organ and Tissue Donor
Registry (registry).
Under current law, DMV must ask all applicants for original or
renewal drivers' licenses or identification cards if they want
to become organ and tissue donors. On the front of the
application, DMV provides space to give consent to be an organ
and tissue donor upon death. The application includes a
statement on the back explaining that this consent is legally
binding for those 18 and older and that minors require consent
from a parent or guardian. An applicant need not answer in order
to receive a driver's license or identification card .
DMV prints the word "DONOR" inside a pink dot embedded on the
face of the driver's license or identification card of each
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person who signs up and transmits the person's information to
Donate Life California.
A person who applies for a driver's license or identification
card may also designate a voluntary contribution of $2 to
support organ and tissue donation. DMV collects these
contributions, from which it deducts its actual administrative
costs of signing up donors, and then DMV transmits the remainder
to support the work of Donate Life California.
This bill :
1.Requires an applicant for a driver's license or identification
card to check yes or no as to whether to add his or her name
to the organ donor registry. An applicant must answer this
question in order to receive or renew his or her driver's
license or identification card.
2.Requires DMV to update its driver's license and identification
card applications to include yes or no check boxes
specifically stating "Yes, add my name to the donor registry"
or "I do not wish to register at this time." DMV shall also
provide a prescribed explanation on the application of what
checking yes means and information on how to remove one's name
from the registry later by contacting Donate Life.
3.Rewrites the information that DMV shall provide on the back of
the driver's license or identification card application to
clarify that if the applicant is 18 or older, he or she has
actually signed up by checking yes on the front of the
application and to provide more information about what being a
donor means.
4.Requires DMV to report annually for four years, plus provide
quarterly updates, to Donate Life California and the
appropriate policy and fiscal committees of the Legislature
information on funds collected through the voluntary
contributions as well as a summary of applicants, including
non-identifiable information on gender, zip code, year of
birth, and method of application (field office, online, or
mail).
5.Authorizes the OPOs to create the Altruistic Living Donor
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Registrar, which shall establish and maintain the Altruistic
Living Donor Registry for persons who would like to identify
themselves as kidney donors during their lifetimes. This
registrar:
Shall use information in the registry to expedite
matches between donors and potential recipients.
May receive voluntary contributions to support the
registry and other activities.
Shall collect and make available to the public
information on the number of donors on the registry,
changes in the numbers of donors, and general donor
characteristics.
May expand the registry to include living donors of
organs and tissues other than kidneys if it can make a
finding that these types of donations are generally safe,
without significant risk of complications, and would not
adversely affect the health of the donor.
COMMENTS:
1.Purpose . Currently over 21,000 California residents are
waiting for organ transplants. It is estimated that one-third
of these people will die before they are able to receive the
donations that they need. Of those, over 17,000 are waiting
for a kidney transplant, and the waiting list continues to
grow.
This bill alters the process of applying for a new or renewal
driver's license or identification card so that one must
either enroll with the Donate Life California Organ and Tissue
Donor Registry or decline to enroll. The author asserts that
this change will increase the chances that a person will add
him or herself to the registry.
The bill further requires that DMV report annually with
quarterly updates on the funds collected through voluntary
contributions as well as a summary of information about
applicants who consent to be organ donors. With this
information, the organ donation community will know better the
revenues it will receive and will be able to improve its
donor-sign up outreach efforts.
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2.Recent amendments . Recent amendments added Section 1 to this
bill (described above in #5), which authorizes the creation of
a registry for living donors. The subject matter of Section 1
of this bill is properly within in the jurisdiction of the
Senate Health Committee and beyond the purview of this
committee. This analysis, therefore, addresses primarily
Section 2 of the bill relating to the existing donor sign up
and funding program at DMV. Should this bill pass this
committee, the motion should be to pass the bill and re-refer
it to the Senate Rules Committee, so that it may then be
re-referred to the Health Committee for consideration of the
creation of a living donor registration and matching process.
3.Background . SB 108 (Speier), Chapter 740, Statutes of 2001
authorized the establishment of an Organ and Tissue Donor
Registry in the California Health and Human Services Agency.
The agency never received funding for the registry, and in
2003, SB 112 (Speier), Chapter 405, transferred responsibility
for establishing the registry to a private, nonprofit
organization administered by the four federally-designated
OPOs. The four federally-designated OPOs are:
California Transplant Donor Network, which serves 39
counties in northern and central California;
Golden State Donor Services, which serves 11 counties in
the Sacramento region;
Lifesharing Community Organ & Tissue Donation, which
serves San Diego and Imperial Counties; and
OneLegacy, which serves counties in the Los Angeles
area.
SB 112 built on a provision of current law at that time that
required DMV to provide donor registration forms to those
applying for drivers' licenses or identification cards. These
forms included instructions to mail the completed form to
Donate Life California. Donate Life California found this
system an ineffective method of signing up donors, and so in
2005 sponsored, SB 689 (Speier), Chapter 665, which requires
DMV to collect organ and tissue donor designation information
on its applications for drivers' licenses and identification
cards. Donate Life reports that about 25 percent of those
applying or renewing a driver's license or identification card
sign up to be donors. This bill is a further attempt to
increase that percentage.
1.Waiting at DMV . DMV reports that the wait times at its field
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offices have increased dramatically over the past two years.
Annual average wait times for those without appointments
increased from 19 minutes 30 seconds in fiscal year 2007-08 to
41 minutes 20 seconds thus far in the current year. Average
wait times in February and March of this year were over 55
minutes. For those with appointments the times are shorter,
but the rate of increase is about the same with current wait
time averaging about 15 minutes. This bill will exacerbate the
trend of lengthening wait times in DMV offices.
DMV currently processes about 3.75 million driver's license
and identification card applications through its field offices
each year. Under this bill, each of these nearly four million
transactions would require a DMV clerk to confirm that the
applicant has answered whether or not he or she will become an
organ donor, and if the applicant has not answered, the clerk
will have to explain to the applicant that he or she must
answer and then wait while the applicant answers or asks
further questions. This will result in perhaps a short
increase in time spent at the DMV window for that applicant,
but will further exacerbate the increasingly long wait times
for all others awaiting service in DMV's offices.
2.Living donors and the driver's license . This bill provides for
creation of the living donor registration system, and it also
makes changes to the existing process for signing up organ and
tissue donors through DMV. The bill, however, makes no
connection between the two. That is, it does not conceive of
using DMV to sign up living donors.
POSITIONS: (Communicated to the Committee before noon on
Wednesday,
April 7, 2010)
SUPPORT: California Hospital Association
Donate Life California
OPPOSED: None received.