03/21/1994 01:45 PM Senate HES

 VICE-CHAIRMAN SHARP called the Senate Health, Education and Social            
 Services (HESS) Committee to order at 1:45 p.m.  He introduced                
 HB 323  (RELEASE OF CERTAIN DEATH CERT. INFO) as the first order of           
 business before the committee.                                                
                                                                               
 REPRESENTATIVE CYNTHIA TOOHEY, Prime Sponsor, stated that HB 323              
 would facilitate organ and tissue donations.  Over 300 tissue and             
 organ transplants are anticipated this year in Alaska.  She                   
 explained that currently there are restrictions on the release of             
 pertinent information collected by the Department of Health and               
 Social Services (DHSS) which cause delays; potential organ and                
 tissue donors could be lost.  HB 323 would permit pertinent                   
 information from DHSS to be given to a bank, storage facility, or             
 person handling procurement of anatomical gifts within a time frame           
 that would allow successful donation of organs and tissue.  The               
 pertinent information consists of the name of the individual who              
 could execute the anatomical gift, the medical suitability of the             
 potential donor, the contact person to obtain permission in a                 
 timely manner to allow successful harvest, and procedures                     
 specifying circumstances when an anatomical request would be                  
 inappropriate.  Representative Toohey noted support from the Alaska           
 Medical Association, DHSS, and the court systems.  HB 323 also has            
 two zero fiscal notes.  She pointed out that HB 323 passed the                
 House unanimously.                                                            
                                                                               
 SENATOR LEMAN supported organ and tissue donation.  He inquired as            
 to the time period for successful donation of an organ or tissue.             
                                                                               
 Number 083                                                                    
                                                                               
 JENS SAAKVITNE, Director of Life Alaska, Inc., informed the                   
 committee that after the heart stops, only tissue can be donated.             
 Tissue donation can be accepted up to twenty-four hours after the             
 heart stops.                                                                  
                                                                               
 SENATOR LEMAN inquired as to the procedures regarding the contact             
 of the next of kin.  He asked who would be asking the department              
 for the pertinent information and how would that information                  
 provide knowledge of medical suitability for donation.                        
                                                                               
 JENS SAAKVITNE stated that the initial medical suitability would be           
 determined by the decedent's age and the suspected cause of death.            
 He explained that in 90 percent of the cases the coroner or a                 
 police officer would have the initial information for screening and           
 they have about an 80 percent accuracy rate.                                  
                                                                               
 SENATOR LEMAN asked what information could be provided by the                 
 department in the immediate turnaround that would be beneficial.              
 JENS SAAKVITNE explained that currently the coroner only releases             
 the decedent's name and time of death.  The other pertinent                   
 information is left for the procurement organization to find.  Mr.            
 Saakvitne stated that they would be interested in the decedent's              
 age, the suspected cause of death, the next of kin, and a way to              
 contact them.  Mr. Saakvitne noted that when calling the next of              
 kin, he identifies himself, his affiliation, and the fact that he             
 is an information and support system resource.                                
                                                                               
 SENATOR LEMAN asked if HB 323 provides any protection against an              
 organ or tissue procurement organization being the first caller to            
 the next of kin.  JENS SAAKVITNE stated that the coroner would not            
 release the name of the decedent until the next of kin had been               
 notified.  The language of HB 323 states that the information "may"           
 be released, which places a lot of responsibility on the organ and            
 tissue procurement organization.  Mr. Saakvitne explained that they           
 never try to talk a family into donation; their responsibility is             
 to let the family know of this option.                                        
                                                                               
 SENATOR LEMAN inquired of the actual procedure to be followed in              
 the case of a possible organ or tissue donation.                              
                                                                               
 Number 190                                                                    
                                                                               
 AL ZANGRI, Chief of the Bureau of Vital Statistics for the                    
 Department of Health and Social Services, explained that Life                 
 Alaska calls the coroner or the medical examiner daily to identify            
 potential donors.  The department in Juneau would never be                    
 involved; it would be done through the medical examiner's office in           
 Anchorage or through the various state coroners.  The medical                 
 examiner and coroner are on call twenty-four hours a day and they             
 are called in every case.                                                     
                                                                               
 REPRESENTATIVE CYNTHIA TOOHEY clarified that Life Alaska or another           
 procurement organization would call the family.                               
                                                                               
 SENATOR LEMAN asked who would involve the department.  He posed an            
 accident situation when asking who would call and involve others.             
 AL ZANGRI said that the police or the investigating officer would             
 call the coroner's office.  If the coroner's office decides to take           
 jurisdiction they would notify the medical examiner.  Mr. Zangri              
 noted that the medical examiner is the first individual in the                
 department who would be notified of a potential death and possible            
 organ or tissue donation.  At this point, the pertinent information           
 has been collected and is present in the coroner and the medical              
 examiner's files.  Generally, a call from a procurement                       
 organization occurs within the next few hours in order to obtain              
 the pertinent information.                                                    
                                                                               
 SENATOR ELLIS asked if the transplant agencies referred to in the             
 sponsor statement are required to be licensed.  JENS SAAKVITNE                
 stated that Alaska does not require licensure.  Life Alaska is                
 licensed as a non profit agency and Northwest Organ Procurement               
 Agency is an independent agency.  In Alaska, Life Alaska is the               
 only agency dealing with transplants after the heart has stopped.             
                                                                               
 SENATOR ELLIS requested that Representative Toohey go over her                
 notion that a decedent's family could find a certain comfort after            
 permitting donation.                                                          
                                                                               
 REPRESENTATIVE CYNTHIA TOOHEY noted the many invaluable donations.            
 She explained that donation often gives the family solace because             
 perhaps, it could help someone else.                                          
                                                                               
 Number 271                                                                    
                                                                               
 SENATOR ELLIS asked if the decedent's family would receive more               
 information under HB 323.  JENS SAAKVITNE said that the information           
 for the decedent's family would stay the same.  Mr. Saakvitne                 
 explained that currently within five weeks of the death and                   
 donation, the family will receive a letter outlining the transplant           
 while maintaining confidentiality.  The decedent's family is                  
 entered into a one year bereavement program which serves as a                 
 support system.  REPRESENTATIVE CYNTHIA TOOHEY felt that                      
 confidentiality was as it should be.                                          
                                                                               
 SENATOR ELLIS requested that the issue of fetal tissue be addressed           
 regarding HB 323.  JENS SAAKVITNE informed the committee that the             
 standard for tissue transplant purposes is from birth to age                  
 seventy or eighty.  There is no use for transplant of fetal tissue.           
 From full-term birth on, there are some donation options.  Mr.                
 Saakvitne noted that they are required to document the infant's               
 heartbeat.                                                                    
                                                                               
 SENATOR ELLIS asked if that requirement was due to a law or a moral           
 feeling.  JENS SAAKVITNE said that documenting the infant's heart             
 beat was not due to a law or a moral feeling.  Fetal tissue cannot            
 be used for transplant because the tissue is not large enough or              
 developed enough.  Mr. Saakvitne said that the only research he was           
 involved with was for knee or shoulder joint requests by                      
 physicians.  Mr. Saakvitne emphasized that he would not be involved           
 in a research donation for anything less than a full-term birth.              
                                                                               
 SENATOR SALO moved HB 323 out of committee with individual                    
 recommendations.  Hearing no objections, it was so ordered.