BILL ANALYSIS
SB 1395
Page 1
Date of Hearing: June 28, 2010
ASSEMBLY COMMITTEE ON TRANSPORTATION
Bonnie Lowenthal, Chair
SB 1395 (Alquist) - As Amended: June 14, 2010
SENATE VOTE : 35-0
SUBJECT : Organ donation
SUMMARY : Requires driver's license applicants to indicate
whether or not they choose to be organ donors. Specifically,
this bill :
1)Makes findings and declarations regarding the need for organ
donors and the intent of the Legislature to establish an
Altruistic Living Donor Registry (Altruistic Registry).
2)Authorizes California organ procurement organizations to
establish a not-for-profit entity designated as the Altruistic
Living Donor Registrar (Altruistic Registrar), which would
establish and maintain an Altruistic Registry.
3)Requires the Altruistic Registry to contain information
regarding persons who have identified themselves as altruistic
living kidney donors and to be designed to promote and assist
live kidney donations, including paired exchanges and
nondirected donations.
4)Makes the Altruistic Registrar responsible for developing
methods to increase the number of donors who enroll in the
Altruistic Registry and requires him or her to make available
to the federally designated organ procurement organizations
and transplant centers in California information contained in
the Registry regarding potential altruistic living donors.
5)Requires this information to be used to expedite a match
between identified organ donors and potential recipients.
6)Allows the Altruistic Registrar to receive voluntary
contributions to support the Altruistic Registry and its
activities.
7)Requires the Altruistic Registrar to collect and make
specified information relating to altruistic kidney donations
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available to the public.
8)Allows the Altruistic Registrar to authorize the Altruistic
Registry to include persons who identify themselves as
altruistic living donors of organs and tissue other than
kidneys to be added to the Registry, upon a finding by the
Registrar that the donation is generally regarded as safe and
without a significant risk of complications, and would not
adversely affect the health of the donor. Upon making such a
finding, the Registrar would be required to notify the
appropriate policy committees of the Legislature.
9)Requires, on and after July 1, 2011, an application for a new
or renewal driver's license or identification (ID) card to
contain a space for the applicant to enroll in the Donate Life
California Organ and Tissue Donor Registry (Donor Registry).
10) Requires the application to include check boxes for an
applicant to mark either, "Yes, add my name to the donor
registry," or "I do not wish to register at this time."
11) Requires the Department of Motor Vehicle (DMV) to inquire
verbally of an applicant applying in person for an original or
renewal driver's license or ID card at a DMV office as to
whether the applicant wishes to enroll in the Donate Life
California Organ and Tissue Donor Registry. Failure or
refusal to answer this question or check a box on the
application form would not constitute a basis for DMV to deny
an applicant a driver's license or ID card.
12) Requires the driver's license and ID card applications to
include the statement: "Marking 'Yes' adds your name to the
Donate Life California Organ and Tissue Donor Registry and a
pink 'donor' dot will appear on your license. If you wish to
remove your name from the registry you must contact Donate
Life California (see back); DMV can remove the pink dot from
your licenses but cannot remove you from the registry."
13) Requires the backs of the applications to contain the
statement: "If, on the front of this form, you marked 'Yes' to
register as an organ and tissue donor you are legally
authorizing the recovery of organs and tissues in the event of
your death. Registering as a donor will not affect your
medical treatment in any way. As outlined in the California
Anatomical Gift Act, your authorization is legally binding
and, unless the donor is under 18 years of age, your decision
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does not require the consent of any other person. For
registered donors under 18 years of age, the legal guardian
shall make the final donation decision. You may limit your
donation to organs or tissues, place usage restrictions, for
example transplantation or research, obtain more information
about donation, or remove your name from the registry on the
Internet Web site of Donate Life California:
www.donateLIFEcalifornia.org ."
14) Requires DMV to transmit to the Donor Registry and the
appropriate policy and fiscal committees of the Legislature an
annual report, and to make available quarterly updates,
detailing funds collected through voluntary contributions as
well as a summary of applicants, including date and method of
application, donor registration status, zip code, gender, and
year of birth.
15) Provides that the requirement for submitting the annual
report is inoperative four years after the date the first
annual report is due.
EXISTING LAW :
1)Requires the front of an application for an original or
renewal of a driver's license or ID card to contain a space
for an applicant to give his or her consent to be an organ and
tissue donor upon death.
2)Requires an applicant who gives consent to be directed to read
a statement on the back of the application that contains
specified information regarding organ donation.
3)Requires DMV to collect donor designation information on all
applications for an original or renewal driver's license or ID
card.
4)Requires DMV to print the word "DONOR" or another appropriate
designation on the face of a driver's license or ID card to a
person who registered as a donor.
5)Requires DMV, on a weekly basis, to electronically transmit to
Donate Life California specified information on every
applicant who has indicated his or her willingness to
participate in the organ donation program.
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6)Allows driver's license and ID card applicants to designate a
voluntary contribution of $2 to Donate Life California to be
collected by DMV for the purpose of promoting and supporting
organ and tissue donation.
7)Requires the donor enrollment form to be posted on the
Internet Web sites for DMV and the California Health and Human
Services Agency.
FISCAL EFFECT : Unknown. This bill was withdrawn from the
Senate Appropriations Committee pursuant to Senate Rule 28.8.
COMMENTS : 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's sponsor, Governor Arnold Schwarzenegger, states:
"Organ donation is one of the kindest, most generous and
powerful actions that each and every one of us can take. With
thousands of people in California and throughout the nation
currently waiting for a transplant, this legislation represents
a new and important resource to increase donor rates. I am
excited to partner with the legislature to implement this
life-saving legislation and make California a leader in organ
donations."
A major portion of this bill deals with the establishment of an
Altruistic Living Donor Registry to facilitate the donation of
kidneys from living donors. These provisions have no
transportation implications. The balance of the bill affects
DMV in that it alters the process of applying for a new or
renewal driver's license or ID card so that an applicant must
either enroll with the Donor Registry or decline to enroll. If
an applicant fails to check the Yes or No box, the DMV clerk
would be required to prompt the applicant to indicate his or her
choice. The author asserts that this change will increase the
chances that a person will add him or herself to the Donor
Registry.
The bill further requires that DMV report annually, as well as
provide 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
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information, the organ donation community will know better the
revenues it will receive and will be able to improve its donor
outreach efforts.
SB 108 (Speier), Chapter 740, Statutes of 2001 authorized the
establishment of a 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 organ procurement organizations.
SB 112 (Speier), Chapter 405, Statutes of 2003, built on a
provision of then-current law that required DMV to provide donor
registration forms to those applying for drivers' licenses or ID
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
therefore sponsored SB 689 (Speier), Chapter 665, Statutes of
2005, which requires DMV to collect organ and tissue donor
designation information on its applications for drivers'
licenses and ID cards. Donate Life reports that about 25
percent of those applying or renewing a driver's license or ID
card sign up to be donors. This bill is a further attempt to
increase that percentage.
Although DMV continues to struggle with wait times for its
customers, it is unlikely that the added burden of requiring its
clerks to pose to license applicant's follow-up questions on
organ donations will have a significant impact on processing
times and it may, in fact, ultimately result in saving
additional lives.
Author's amendment: Under this bill, the Altruistic Registrar
would be authorized to allow the Altruistic Registry to expand
to include individuals who designate themselves as altruistic
living donors of organs and tissue other than kidneys if the
Altruistic Registrar finds that these types of donations are
generally safe, without significant risk of complications, and
would not adversely affect the health of the donor. The author
agreed in the prior committee to amend the bill to require such
a determination to be made upon a finding by the federal Centers
for Medicare and Medicaid and the United Network for Organ
Sharing, rather than the registrar. The agreed-to amendment is
as follows: On page 4, line 23, delete "registrar" and insert
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"Centers for Medicare and Medicaid (CMS) and the United Network
for Organ Sharing (UNOS)"
REGISTERED SUPPORT / OPPOSITION :
Support
Governor Arnold Schwarzenegger (sponsor)
American Federation of State, County and Municipal Employees
California Academy of Physician Assistants
California Hospital Association
California Medical Association
Community Health Partnership
DaVita Dialysis
Donate Life California
El Camino Hospital
National Kidney Foundation
Santa Clara County
Stanford Hospital and Clinics
Opposition
None on file
Analysis Prepared by : Howard Posner / TRANS. / (916) 319-2093