HB 420-ANATOMICAL GIFTS 3:08:49 PM CHAIR WILSON announced that the first order of business would be HOUSE BILL NO. 420, "An Act relating to the Uniform Anatomical Gift Act, to anatomical gifts, to donations to the anatomical gift awareness fund, to a registry of anatomical gifts, and to organizations that handle the procurement, distribution, or storage of all or a part of an individual's body." 3:10:04 PM REBECCA ROONEY, staff to Representative Peggy Wilson, Alaska State Legislature, provided a sectional review, on behalf of the sponsor, paraphrasing from a prepared statement, which read as follows [original punctuation provided]: Although 24 pages in length, HB 420 is basically a cleanup bill that updates Alaska statutes regarding organ donation. There is a piece of model legislation called the Uniform Anatomical Gift Act that serves to harmonize organ and tissue donation laws in all 50 states and the federal government. The UAGA has been doing this for over 40 years. Alaskan statues regarding organ donation are already based on the UAGA, but they are modeled after the last significant update, which was in 1987. HB 420 brings Alaskan statutes in line with the most recent version, the 2008 Revised UAGA. The Department of Law, the Department of Health and Social Services, the State Medical Examiners Office, Life Alaska Donor Services, and representatives of the National Conference of Commissioners on Uniform State Laws were involved in the development of the bill language to ensure a sound piece of legislation and so far everyone has been happy with the results. Madam Chair, at this very moment, an estimated 180 Alaskans are in need of a life-saving transplant and waiting for a donated organ to become available. Hundreds more are waiting for tissue transplants. Because the bill is basically a realignment of statutes with the 2008 Uniform Anatomical Gift Act language, I won't go through all the recommended changes. You have a sectional in front of you that attempts to explain them. 3:12:32 PM MS. ROONEY then offered a panel of expert witnesses to answer questions. The committee took an at-ease from 3:12:57 PM to 3:15:04 PM. 3:15:06 PM REPRESENTATIVE ROSES asked for clarification of the refusal language on page 6, beginning at line 18, of the bill. 3:15:38 PM DEBORAH BEHR, Chief Assistant Attorney General, Legislation & Regulations Section, Civil Division, Department of Law, explained that a donation of an anatomical gift is a totally voluntary act and the refusal provision allows an individual to set out in a document one's decision to not donate an anatomical gift of their body. 3:16:31 PM REPRESENTATIVE ROSES asked whether the bill creates a situation wherein the only way to prevent an anatomical gift is to make the provision to refuse. 3:16:53 PM MS. BEHR explained that most provisions in Alaska are made by the approval on one's driver's license. However, in the case of an untimely death of a person who has not indicated a decision, the family is left to decide. In fact, other provisions of HB 420 address that situation. 3:18:07 PM CHAIR WILSON asked Ms. Behr to elaborate. 3:18:15 PM MS. BEHR further explained that making a gift while you are still alive can be done by the driver's license. For someone dying in a hospital, instructions can be given to the doctors and nurses. 3:18:51 PM REPRESENTATIVE GARDNER asked whether the current language in the bill differs in any way from the Uniform Anatomical Gift Act (UAGA). 3:19:15 PM MS. BEHR responded that this bill contains some minor changes to deal with the operation of the medical examiner's office in Alaska. 3:20:09 PM REPRESENTATIVE GARDNER surmised that in all other respects this bill would ensure that Alaska is in conformity. MS. BEHR said yes. She added that, in a crisis situation, it is important that the doctors and emergency medical technicians (EMTs) know the law. Further, other states can be involved and the uniformity of the law is critical. 3:20:48 PM JAY BUTLER, M.D., Chief Medical Officer, Office of the Commissioner, Department of Health & Social Services, stated that the bill institutionalizes procedures that the state medical examiner has been practicing in conjunction with the donor agencies. 3:21:14 PM REPRESENTATIVE GARDNER expressed her interest in the material differences in the law that have to do with the individual's choices and family involvement. 3:21:41 PM REPRESENTATIVE CISSNA asked whether the language in the bill would still allow Alaskans the freedom to express their wishes appropriately. 3:23:05 PM MS. BEHR opined that the advantages of the UAGA is that it strengthens individual decision making by clearly stating what an individual's wishes are about giving an anatomical gift. If one's wishes have not been expressed, this bill incorporates a provision to direct how that situation would be addressed. For example, the majority opinion of children would prevail in a decision regarding a parent. Ms. Behr continued to explain that the statute recognizes the validity of donor registries, state issued identification cards, and electronic transmissions for the expression of will. She concluded that the improvements in this bill are endorsed by over twenty states and many medical associations. 3:25:28 PM REPRESENTATIVE GARDNER asked whether there was access to the donor registry in the instance of a lost or misplaced identification card. MS. BEHR indicated yes. In fact, the registry is available to EMTs in an emergency situation. 3:26:12 PM REPRESENTATIVE ROSES called the committee's attention to page 14, line 10, of the bill and read: A hospital in this state shall enter into agreements or affiliations with procurement organizations for coordination of procurement and use of anatomical gifts. REPRESENTATIVE ROSES then asked whether this was a new or an existing provision. 3:26:59 PM BRUCE ZALNERAITIS, Chief Executive Officer, Life Alaska Donor Services (LADS), stated that for the last 15 years, Life Alaska Donor Services (LADS) has had signed agreements with all of Alaska's hospitals to allow for the process of donation and the recovery of organs and tissues for transplantation, research, and education. Mr. Zalneraitis paraphrased from a prepared statement, which read as follows [original punctuation provided]: We, at Life Alaska Donor Services, would like to express our strong support for [HB 420, the companion bill to] SB 181, The Revised Uniform Anatomical Gift Act that will better facilitate the donation process in Alaska. There are close to 100,000 people waiting for an organ transplant in the U.S. and around 180 patients waiting in Alaska. Eighteen people in the U.S. die each day while waiting for an organ transplant. It is important to simplify and clarify the process of becoming an organ and tissue donor. [HB 420, the companion bill to] SB 181 will update Alaska's UAGA [Uniform Anatomical Gift Act] to the 2006 version from the 1987 version and will remove obstacles to organ and tissue donation by clarifying language on who can grant consent to organ donation. It also recognizes the benefits of donor registries. Alaska's first-person consent donor registry is now over 330,000 citizens and continues to grow at 800 people per week, mostly through DMV sign-ups. The revised UAGA version also prioritizes donation for transplantation over research. [HB 420, the companion bill to ] SB 181 also further improves the relationship between the donation organizations and the medical examiner's office. The medical examiner plays a key role in the donation process as most organ and tissue donations involve sudden, unexpected deaths which fall under the jurisdiction of the medical examiner. 3:29:26 PM SHERRY BADILLO, donor mother, related the loss of her 17 year- old daughter due to a car accident. Her daughter had a signed donor card and became a skin, tissue, ligament, and bone donor, whose gift benefitted 48 people across the nation, from age 6 to 65 years of age. As a donor mother, she believes that her daughter's legacy lives on, and knowing this has helped her to cope with the loss of her daughter. Ms. Badillo urged everyone to carry a donor card and to make their wishes known. Recently, her father became a donor, in memory of his granddaughter, and lives on as well. 3:32:35 PM CHAIR WILSON thanked Ms. Badillo for her testimony. 3:32:41 PM REPRESENTATIVE ROSES praised Ms. Badillo for her positive influence on others. 3:33:02 PM MS. BADILLO stressed the importance of the mission of Life Alaska Donor Services. 3:33:20 PM CHAIR WILSON observed that it is great to know how many have benefited from the gift. MS. BADILLO advised that, because of the Health Insurance Portability and Accountability Act (HIPAA), it is now up to the recipient to contact the donor or sponsor family after the receipt of an anatomical gift. 3:34:43 PM KIM MCGEE, organ recipient, informed the committee that she is a two organ recipient and received a pancreas and a kidney transplant 20 months ago. She expressed her gratitude for the law and stated that recipients are aware of, and grateful for, the decisions made by donors and donor families. She shared her experience as a diabetic in poor health for 38 years prior to her transplant. Ms. Mcgee stated that her life completely changed when she received the transplant, and she stressed the importance of registering as organ donors. In response to a question, Ms. Mcgee said that she takes good care of her health and protects her new organs. 3:39:00 PM CHAIR WILSON closed public testimony. 3:39:21 PM CHAIR WILSON said that the testimony from a donor parent and a recipient was meaningful. 3:39:44 PM REPRESENTATIVE GARDNER asked whether there are transplant facilities in Alaska. 3:39:59 PM DR. BUTLER indicated not; however, there are procedures addressed in the bill that can be performed in the state. 3:40:23 PM REPRESENTATIVE GARDNER moved to report HB 420 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 420 was reported out of the House Health, Education and Social Services Standing Committee with individual recommendations and the accompanying zero fiscal note.