BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Elaine K. Alquist, Chair
BILL NO: SB 1395
S
AUTHOR: Alquist
B
AMENDED: April 5, 2010
HEARING DATE: April 21, 2010
1
CONSULTANT:
3
Dunstan/
9 5
SUBJECT
Organ donation
SUMMARY
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.
Authorizes creation of a living donor registry to sign up
kidney donors.
CHANGES TO EXISTING LAW
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), which is
Donate Life California.
Requires that the Department of Motor Vehicles (DMV) to ask
all applicants for original or renewal drivers' licenses or
identification cards if they want to become organ and
tissue donors. Allows a person who applies for a driver's
license or identification card to designate a voluntary
contribution of $2 to support organ and tissue donation.
Requires DMV to collect these contributions, deduct a
portion for the administrative costs of signing up donors,
Continued---
STAFF ANALYSIS OF SENATE BILL 1395 (Alquist) Page 2
and then transmit the remainder to support the work of
Donate Life California.
Establishes the Uniform Anatomical Gift Act (UAGA) which
governs donations of body parts that are anatomical gifts.
The UAGA contains provisions relating to the anatomical
gift process, including who may make a gift, how to
document a gift or refusal, how to amend or revoke a gift,
to whom a gift may be made and delivery of a gift.
Requires DMV to print the word "DONOR" on the face of the
driver's license or identification card of each person who
signs up and to transmit each person's information to
Donate Life California.
This bill:
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" for
the purpose of allowing an applicant to enroll with the
Donate Life California Organ and Tissue Donor Registry.
Directs DMV to provide a specific 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. Requires that an applicant answer
this question in order to receive or renew his or her
driver's license or identification card.
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 years old 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.
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).
Authorizes the OPOs to create the Altruistic Living Donor
STAFF ANALYSIS OF SENATE BILL 1395 (Alquist) Page 3
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.
Allows the registrar to receive voluntary contributions to
support the registry and other activities. Requires the
registrar to 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. Authorizes the registrar to expand the
registry to include living donors of organs and tissues
other than kidneys if the registrar 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.
Makes other technical and clarifying changes.
FISCAL IMPACT
This bill has not been analyzed by a fiscal committee.
BACKGROUND AND DISCUSSION
The author argues that, in the face of the great need to
find suitable donors, California needs to improve its
efforts at adding donors to the California Organ and Tissue
Donation Registry. The author points to the figures from
Donate Life that shows that over 20,000 individuals are on
the waiting list waiting for an organ transplant.
According to the author, SB 1395 would create the first
altruistic living donor registry in the country and this
new registry would be composed of individuals who are
willing to donate a kidney to help others and would be
administered by Donate Life. The author notes that kidneys
can be donated by a living donor through a fairly simple
and safe medical procedure and the registry will speed the
match between organ donors and recipients. The author
argues that there is a great need for this registry which
seeks to increase the number of potential kidney donors,
thereby helping to reduce the largest component of the long
recipient waiting list. The author notes that only 27
STAFF ANALYSIS OF SENATE BILL 1395 (Alquist) Page 4
percent of DMV customers check yes to designate themselves
as organ donors and that although that level is up from 20
percent four years ago, we can do better . The author
argues that adding a "no" box, as simple as it seems, will
improve the donation rate by allowing DMV to ask customers
to answer the donation question.
Organ and tissue transplants
Organ and tissue donation is the process for recovering
organs and tissues from a deceased person and transplanting
them to others in order to save or enhance the lives of
those in need. Since the adoption of the first UAGA in
1967, there have been substantial improvements in the
practice of organ, eye and tissue transplantation and
therapy. Also, the need for organs, eyes, and tissue for
research and education has increased to assure more
successful transplantation and therapies.
Up to 8 lives can be saved through organ donation, and
another 50 lives may be improved through tissue donation,
from a single donor. The most commonly transplanted organs
are kidneys, liver, heart, and lungs. As for tissues: (a)
skin is used as a temporary dressing for burns, serious
abrasions and other exposed areas; (b) bone is used in
orthopedic surgery to facilitate healing of fractures or
prevent amputation; (c) heart valves are used to replace
defective valves; (d) tendons are used to repair torn
ligaments on knees or other joints; (e) veins are used in
cardiac by-pass surgery; and (f) corneas can restore sight
to the blind. Many tissues that cannot be used for
transplant can be recovered and used in a variety of
research studies in order to advance medical science.
There are over 20,000 California residents waiting for
organ transplants. It is estimated that one-third of these
people will die before they are able to receive a donation.
California Organ and Tissue Donation Registry
The four federally designated OPOs established Donate Life
California as the Registrar in 2004. Donate Life
California then established and continues to maintain the
California Organ and Tissue Donor Registry. The four OPOs
in California are the California Transplant Donor Network,
in northern and central California; Golden State Donor
Services, in the Sacramento region; Lifesharing Community
STAFF ANALYSIS OF SENATE BILL 1395 (Alquist) Page 5
Organ & Tissue Donation, in San Diego and Imperial
Counties; and OneLegacy, in the Los Angeles area. The
registry allows Californians who are at least 18 years of
age to register their authorization to donate specific or
all organs or tissue upon death. Children between the ages
of 13 and 17 can join the registry, but a minor's parent or
legal guardian is allowed to make the final decision about
organ and tissue donation at the appropriate time. The
registry allows individuals to sign up as donors online.
According to Donate Life California, there are
approximately six million individuals who have signed up in
the registry.
Prior legislation
AB 1689 (Lieber), Chapter 629, Statutes of 2007, repeals
and reenacts the Uniform Anatomical Gift Act (UAGA) into
the Revised UAGA to allow anatomical gifts (gifts)
SB 630 (Dutton), Chapter 138, Statutes of 2005, repealed
the sunset date and clarified provisions of the law
governing organ procurement from a decedent whose death
requires an inquest.
SB 689 (Speier), Chapter 665, Statutes of 2005, required
DMV to collect organ and tissue donor designation
information on its applications for drivers' licenses and
identification cards, and linked DMV with the registry.
AB 777 (Dutton), Chapter 309, Statutes of 2003 established
procedures for removal of organs for transplant when
requested by a qualified organ procurement organization in
the case of an anatomical gift from a decedent whose death
requires an inquest by the medical examiner or coroner.
SB 112 (Speier), Chapter 405, Statutes of 2003, transferred
responsibility for establishing the California Organ and
Tissue Donation Registry to a private, nonprofit
organization administered by the four federally designated
OPOs.
SB 108 (Speier), Chapter 740, Statutes of 2001, authorizes
the establishment of the California Organ and Tissue
Donation Registry in the California Health and Human
Services Agency.
Arguments in support
STAFF ANALYSIS OF SENATE BILL 1395 (Alquist) Page 6
Governor Schwarzenegger, the sponsor of the bill, argues
that this bill does two important things, specifically
requiring driver's license applicants to either
affirmatively register to be an organ donor or allow the
choice to be made at another time and creating the first in
the nation live donor registry to facilitate kidney
donations. Donate Life California argues that the
provision establishing an altruistic living donor registry
for the state will save and improve the lives of people
facing kidney failure by decreasing the amount of time they
spend on dialysis and increasing the quality and number of
living donor transplants in California. They point out
that over 900 lives have been saved by registered organ
donors and tens of thousands more healed by registered
tissue donors and that this bill will help decrease the
state's waiting list for a kidney by inspiring Californians
to consider becoming living kidney donors.
PRIOR ACTIONS
Senate Transportation and Housing: 8-0
COMMENTS
The author agreed to amendments in Senate Transportation
and Housing Committee. These amendments are to be taken in
Senate Health Committee. The amendments would delete from
the bill the requirement that an applicant for a driver's
license or identification card must either enroll as an
organ donor or decline to do so. Instead, the author
agreed to amend the bill to change the application and the
process of applying at a DMV office for a driver's license
or identification card to ensure that the applicant is more
clearly asked his or her intentions.
POSITIONS
Support: Governor Arnold Schwarzenegger (sponsor)
California Academy of Physician Assistants
California Hospital Association
Donate Life California
STAFF ANALYSIS OF SENATE BILL 1395 (Alquist) Page 7
National Kidney Foundation
Oppose: None received
-- END --