SB 181-ANATOMICAL GIFTS  CHAIR MCGUIRE announced the consideration of SB 181. She said it is a uniform clean-up bill. TREVOR FULTON, Staff to Senator McGuire, Alaska State Legislature, Juneau, said SB 181 is a technical bill. It is straightforward and aims to save lives. It updates and clarifies the statutes dealing with anatomical gifts in order to ensure that badly needed organ and tissue donations get to those who need them. There have been significant changes in the donation and transplant field, and SB 181 draws on the federal Uniform Anatomical Gift Act, which is a very good template and has harmonized anatomical gift laws in all 50 states. In drafting SB 181, he worked with the Department of Law, Department of Health and Social Services, the state medical examiner's office, Life Alaska Donor Services, and representatives of the National Conference of Commissioners on Uniform State Laws to ensure a sound piece of legislation. Currently, 180 Alaskans are waiting for organ donations, and hundreds more are waiting for tissue transplants. SB 181 encourages and facilitates badly needed donations, which can save and improve lives all over the state and country. 9:41:17 AM SENATOR BUNDE said he supported other organ and tissue donor bills, and he asked why there is this third bill. MR. FULTON said it is not extending power or authority. It is bringing Alaska statutes up to speed with the federal act. 9:42:43 AM MICHAEL GERAGHTY, Commissioner, Uniform Law Commission, Anchorage, said the original act was passed in 1968 by all 50 states. There are a lot of experiences to draw on since then. There have been changes with electronic records, for example. The revised act was just promulgated by the National Conference of Uniform Law Commissioners in 2006, and it has been adopted in over 20 states in substantially the same form as SB 181. The bill strengthens first-person consent for organ and tissue donations. It bars others from revoking a gift once the decision has been made. Gifts by family members are facilitated if the deceased has not acted to refuse to make an anatomical gift. It can include a health care agent or a grandchild, for example. If a person has not refused to make a gift, the act clarifies who can make a decision on his or her behalf. The bill outlines how donor registries can be used, and identification cards are authorized. A number of states have created state-sponsored registries, and Alaska is one of those states. 9:45:57 AM MR. GERAGHTY said SB 181 provides for coordination between procurement organizations and medical examiners. The language minimizes conflicts when a potential donor is under the jurisdiction of the medical examiner. It clarifies how the donor organization can work with the medical examiner's office to maximize the chances of getting a donation. The bill includes rules to deal with those kinds of potential conflicts. It harmonizes the uniform act with federal law and current practices, including the use of do-not-resuscitate directives. 9:47:32 AM CHAIR MCGUIRE asked him to discuss uniform laws. MR. GERAGHTY said the Uniform Law Commission began in 1916, and it identifies topics where uniform laws would benefit the states. He noted the uniform commercial codes. The National Conference of Commissioners drafts laws that need to be uniform across all states. Each state has representative commissioners. After much deliberation the group creates a uniform act for the states to use. Uniformity is really important for organ donation. Transplant decisions need to be made within minutes or hours of someone's death. The donor may be in one jurisdiction, the recipient in another, and the families may be in another. With no time to spare, uniformity is critical in facilitating the transplantation. The original act worked effectively, but things have been learned so the national conference updated the act in 2006. Many states have acted quickly in adopting it, and he sincerely hopes Alaska joins them. 9:50:02 AM SENATOR STEVENS said most people go outside for a transplant. He understands harmonizing. Are there more transplants in Alaska? BRUCE ZALNERAITIS, Chief Executive Officer, Life Alaska Donor Services, Anchorage, said Alaska does many tissue transplants but no organ transplants. Most are done in specific Seattle hospitals. Expertise is needed to perform these procedures, including the surgery and post-operative care. When an Alaskan is a donor, the organs are made available to patients in the Northwest, which includes Alaskans. SENATOR STEVENS surmised that this law will not have an impact on Alaska hospitals, but will impact Alaska donors. MR. ZALNERAITIS said the donation would be made in Alaska and then shipped to the center. 9:52:59 AM MR. ZALNERAITIS said there are 100,000 patients waiting for organs, and about 180 are Alaskans. About 18 people in the United States die each day while waiting for a transplant that never comes. SB 181 will update the act, remove obstacles by defining who can grant consent, and recognizes the benefits of donor registries. Alaska has a very successful donor registry with 330,000 Alaskans that grows by about 800 per week. The bill prioritizes donations over research and education, and it further improves the relationship between donation organizations and the medical examiner, who plays a key role. 9:54:47 AM SENATOR BUNDE said if there are 800 donors each week, one needs to assume there are far more driver's licenses issued each week, so "we probably ought to assure that people are actually accurate in their application." WHITNEY BREWSTER, Director, Division of Motor Vehicles (DMV), said she does not oppose this legislation. SENATOR BUNDE asked if there are 800 new donors per week. 9:56:00 AM MS. BREWSTER said she doesn't know, but the bulk of the registry comes through the DMV, and it is close to 90 percent. MR. ZALNERAITIS said the DMV provides more than 98 percent of all people signing up as donors. ROBERTA PYRAH, Mother of an organ donor, Palmer AK, noted the importance of the registry. Her son died in 2001. When he got his driver's license that year he was asked if he wanted to be an organ donor. He joked about it. Unfortunately six months later the decision was put upon her and her husband for making her son an organ and tissue donor, based on what he would have done himself. It is important to know about the transplant process and to know that it is not a scary thing. It is something to help others. She is proud that her son's donation has saved a life and improved the lives of thirteen individuals in the Northwest. It is important that youth know about it, and the registry with the DMV is very important. 9:59:43 AM ROBERT MEYER, Heart recipient, Anchorage, said he has received two heart transplants in 2003 from the University of Washington. He has two special families to thank for his continued life. Streamlining the process of organ and tissue donation is extremely important. The faster the process moves, the better, because the wait is agonizing. In hind sight his wait was relatively short. His first transplant failed on the table, and he was kept alive by a machine for four days, and then he was fortunate enough to receive a second transplant from a young man in Montana. There is a young child in California who has been waiting for two years. Anything that can be done to simplify and create uniformity would be very helpful. 10:02:47 AM SCHAEFFER COX, Fairbanks, said he flew down on a whim to visit the capital and he happened to sit in on this hearing. He said SB 181 is great, but he said to maintain a vigilant stance toward the sanctity of human life and never slide off into valuing one life over another. Make sure there are provisions that recognize the sanctity of human life in the bill. Some people may be deemed somehow less worthy for shear economic reasons. In some countries, prisons have been the source of organ transplants. CHAIR MCGUIRE said this bill is a cleanup bill, but there are laws governing who can give and how. Any profit or involuntary donations are not allowed. 10:05:30 AM SENATOR GREEN said this bill strengthens that by referring to "after death" instead of "on death". CHAIR MCGUIRE said she will set SB 181 aside to let people understand it.