The Honorable Deborah Ortiz, Chair
Senate Health & Human Services Committee
State Capitol, Room 2191
Sacramento, CA 95814

On behalf of the four federally designated Organ Procurement Organizations (OPOs) in California*, I am respectfully informing you of their opposition to SB 38 (Denham) which authorizes potential organ donors to prohibit the use of their organs for incarcerated persons. We understand the divergent views on this subject, but disagree with the basic principle of the bill.

The OPOs believe that SB 38 will not be helpful to the goal of increasing organ and tissue donations in that it will establish a hierarchy of "acceptable" recipients. Sadly, far too many persons throughout California die while on a waiting list due to the shortage of organ donors. Many of these lives could be saved if more persons would say “yes” to donation. Under the current system, needy patients are placed on the national waiting list by their individual transplant centers after appropriate medical evaluation. OPOs, which handle recovery and placement of organs when consent for donation is given, are essentially blinded to who is on the list. No personal information about the recipient is available to them. Organ allocation in the United States is based upon medical and scientific criteria and is not impacted by a patient's financial, political, social or celebrity status. All the OPO knows is that the recipient is in desperate need of a life-saving transplant. We believe that the current system provides the most fair, objective and equitable manner of organ allocation and ensures that every patient on the waiting list has an equal chance of receiving an organ.
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*The Coalition on Donation (COD) is composed of the four organizations in California designated by the Health Care Financing Administration pursuant to authority prescribed under the National Organ Transplant Act of 1984 as the official link between organ and tissue donors and individuals awaiting transplantation. COD members work with hospitals to offer the option of donation to families whose loved ones have died. COD members include Golden State Donor Services (Sacramento); California Transplant Donor Network (San Francisco); Lifesharing Community Organ and Tissue Donation (San Diego); and OneLegacy (Los Angeles).

We are very concerned about any effort to move away from this extremely fair system and therefore must oppose SB 38. We very much value the personal commitment to increase organ donation which has been expressed by the author. Unfortunately, we do not share the same view as to the best way to achieve this goal.

C:         California Coalition on Donation
            Senator Jeff Denham
            Members, Senate Committee on Health & Human Services
            Peter Hansel, Consultant
            Debby Rogers, Republican Consultant

FOR INTERNAL USE ONLY

SB 38/AB 289 TALKING POINTS

Updated March 30, 2003

SB 38 (Denham, R-Salinas) would require forms provided by the California Department of Motor Vehicles (DMV) relating to organ and tissue donation (donor cards) “to include a provision allowing the donor to indicate whether he or she desires to prohibit a donation to any person who is incarcerated in state prison or a county jail.” Similarly, AB 289 (Plescia, R-San Diego), would require the same provision in DMV donor cards and the upcoming state donor registry. It also would require the state controller to modify the donor-awareness brochure they are required to include with state pay envelopes each April (in honor of National Donate Life Month), in order to include a notice that donations can be withheld from incarcerated persons.

The California Transplant Donor Network is opposed to any direction that discriminates against any individual or class of persons. The Transplant Network opposes SB 38 and AB 289 because they would discriminate against incarcerated people.

Organ allocation is performed in a fair, objective and equitable manner, so that every patient on the waiting list has an equal chance of receiving an organ. Organ allocation in the United States is based upon medical and scientific criteria, and is not impacted by a patient’s financial, political, social or celebrity status. By changing this blind system to one that establishes a hierarchy of “acceptable” recipients, the system will be degraded and open to further discrimination.

The systems that allocate organs are objective for a reason. If we start deciding who “should” or “should not” receive organs, or priority on the waiting lists, the system immediately becomes subjective. The confidentiality and objectivity of the systems assure that the sickest patients receive organs first, not the richest, the smartest, or the socially acceptable.

The controversy over whether prisoners should receive organ transplants has caused some people to decide against donating their organs when they no longer need them. In Northern and Central California, almost 8,000 people currently are on the national waiting list for organ transplants. These are our sons and daughters, our brothers and sisters, our mothers and fathers, our friends and family. It is not fair for these innocent people to be penalized by those who choose not to be donors because they do not like the state of California’s health policy. Become a donor for them.

·Patients are placed on the national waiting list by their individual transplant centers after appropriate medical evaluation. Organ-procurement organizations (OPOs), which handle recovery and placement of organs when consent for donation is given, are blinded to who is on the list. When a “match” list (the list of recipients that are compatible with a specific donor) is run for organ placement, the OPO knows only the recipient’s name and his/her doctor’s name. No personal information about the recipient is available. All the OPO knows is that the recipient is in desperate need of a life-saving transplant and it is their job to call that person’s transplant surgeon to offer the organ that can provide it.

·Many prisoners in California and the United States have saved the lives of other citizens by donating their organs after death. In fact, many more prisoners have donated organs than have received them.

·This debate would not be occurring if there was not a national organ shortage. That is the issue that needs to be addressed. There are more people on the waiting list than there are donated organs. Approximately one-third of the people on the list will die waiting because of the shortage of organ donors. In 2001, more than 6,000 patients on the national waiting list died waiting. Many of these lives could have been saved if more families had said “yes” to donation.

·The regulations for organ allocation are established by the United Network for Organ Sharing (UNOS), a nonprofit organization that maintains the national transplant waiting list for the U.S. Department of Health and Human Services. The national transplant waiting list is a confidential list of patients who are waiting to be matched with specific donor organs.

The Honorable Deborah Ortiz, Chair
Senate Health & Human Services Committee
State Capitol, Room 2191
Sacramento, CA 9581

On behalf of the four federally designated Organ Procurement Organizations (OPOs) in California*, I am respectfully informing you of our strong support for SB 112 by Senator Jackie Speier. This bill will authorize the transfer of the State Organ Donor Registry from the Health and Human Services Agency to a not-for-profit organization established by the OPOs. The Registry was first authorized in State law in 2002, but growing budget deficits have prevented the Agency from moving forward in an expeditious manner to create this vital tool to encourage donation, house critical authorization for organ and tissue donation, and monitor the success of educational programs.

A statewide database, which is the critical piece of the Registry, would spare family members the anguish of making decisions, speed organs to recipients on waiting lists and make it easier to match compatible hearts, lungs or kidneys. Under SB 112, the Department of Motor Vehicles would still provide donor information cards and the identifying pink dots to driver license applicants. Those who choose to donate organs would then send a special form to the nonprofit group in charge of maintaining the statewide Registry.

A critical shortage of organ donors exists in California. Currently more than 15,000 people in this state are waiting for a life-saving organ. Unfortunately, one-third of them will die waiting because the number of donors lags far behind the number of people needing transplants. A fully operational registry in California would allow us to join thirty-three other states which have registries. They have proven to be very effective in increasing organ donations and in expediting matches. The Registry, a secure database, would provide the legal documentation of a donor's intent beyond the "donor dot" on the license plate and will also provide a way for Californians without drivers' licenses to register themselves as organ, eye and tissue donors.

We believe that privatizing the Registry will allow its implementation in a much more expeditious manner and we strongly urge your AYE vote. Thank you for your consideration of our views.

C:         Senator Jackie Speier
            Members, Senate Health & Human Services Committee
            Peter Hansel, Committee Consultant
            Debby Rogers, Republican Consultant