Legislature(1993 - 1994)
03/21/1994 01:45 PM Senate HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
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.
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