2003 LEGISLATIVE COMPENDIUM Transplantation/Organ Donation

[ Employee Leave for Organ Donation | Organ Donation Education | Medical Examiner Review | Organ Allocation | Whole Body Donation | Transplantation Donation Near Misses | Consent for Corneal Donation | Organ Allocation ]

EMPLOYEE LEAVE FOR ORGAN DONATION

HB 89 by Rep. Ruth Jones McClendon (D-San Antonio) and Sen. Gonzalo Barrientos (D-Austin) mirrors federal employee policy enacted in 1999. The bill allows state employees up to 30 days paid leave to donate an organ, five days for bone marrow donation, and up to one hour per quarter to donate blood (with their supervisor's permission). While not expected to make a huge dent in the waiting list for kidneys, livers, and pancreata, it would, nonetheless, encourage living donation. Fortunately, this time around it received broad support from TMA, the Texas Transplantation Society (TTS), blood banks, and several kidney organizations such as the Texas Renal Coalition and National Kidney Foundation. HB 89 passed in both houses and already has been signed by the governor.

ORGAN DONATION EDUCATION

Senate Bill 160 by Sen. Jane Nelson (R-Flower Mound), as originally introduced, included some controversial allocation passages. However, the committee substitute focused strictly on education measures, thereby gaining broad support. SB 160 requires the Texas Department Health (TDH) to create a program to educate attorneys and others dealing with end-of-life issues on organ donation. It also requires TDH to encourage medical schools to offer advanced courses in organ donation and transplantation to neurosurgery and neurology residents. Funds to create the educational programs will be provided by the Anatomical Gift Education Program, which is funded by the $1 voluntary contribution to the program one can make when renewing drivers licenses and identification cards. TMA and TTS supported the bill.

MEDICAL EXAMINER REVIEW

SB 1225 by Senator Nelson is a technical cleanup bill to add language to the statute governing medical examiner cases and requires justices of the peace and county judges to follow the same procedures that the medical examiner follows in cases requiring an inquest, concerning whether or not to allow organ donation to occur. While most deaths requiring an inquest occur in a county that is part of a medical examiner district, about 5 percent do not, and this bill makes sure that those 5 percent of cases do not slip through the cracks. It was agreed to by not only all of the organ procurement organizations (OPOs) but also representatives from the Justices of the Peace Association and county judges. TTS supported the bill, which has been sent to the governor.

ORGAN ALLOCATION

While SB 1226 by Senator Nelson was more controversial than SB 160 and SB 1225, TTS supported it because it was based on the unanimous recommendations of the Senate Bill 862 Task Force on Organ Allocation. In its final form, it creates a kidney patient pool through which 20 percent of all kidneys donated will be distributed to the people who have been waiting the longest for a transplant and who are not highly sensitized. Even though it passed both houses unanimously , the sharing agreement still will have to be approved at the federal level. The state's three OPOs have 180 days to submit a sharing proposal to the Organ Procurement and Transplantation Network.

WHOLE BODY DONATION

SB 1419 by Sen. Kyle Janek, MD, (R-Houston) addresses the section of the Health and Safety Code that deals with whole body donations. The bill requires the Anatomical Board of the State of Texas to keep identification records of each body donated to the board and of each body or anatomical specimen distributed by the board. The bill requires the board or the board's representative to distribute bodies donated to it and authorizes the board or the board's representative to redistribute bodies donated to medical or dental schools or other donees authorized by the board to certain schools, colleges, and persons. The law takes effect on Sept. 1, 2003.

TRANSPLANTATION/ORGAN DONATION NEAR MISSES

CONSENT FOR CORNEAL DONATION

House Bill 987 by Rep. Garnet Coleman (D-Houston) would have eliminated the provision in current statute that allows for corneas to be taken without consent. The way it was written, however, created stiff penalties that might have discouraged organ donation, as it went beyond the original intent to eliminate presumed consent for corneas. The Texas Ophthalmological Association and TTS opposed the bill, which was left pending in the House Public Health Committee.

ORGAN ALLOCATION

HB 2111 by Rep. Mark Homer (D-Paris), a controversial bill, would have created a new system of organ donation based on the presumed consent model. Under presumed consent, individuals would be presumed to be organ donors unless they had specifically opted out of the donation system by registering their wishes in some type of data bank. Whether it was due to the budget note attached to it or to its controversial nature, the bill never received a hearing. Some patient groups supported the bill. TTS and other major societies such as the American Medical Association and American College of Surgeons have indicated the need to study public opinion and felt it may be premature at this time; therefore, TTS remained neutral.

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