REPORT TITLE:
Organ donation


DESCRIPTION:
Requires referrals of all deaths to an organ procurement
organization.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                            197         
HOUSE OF REPRESENTATIVES                H.B. NO.           
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO ANATOMICAL GIFTS.



BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  The legislature finds that there exists in the
 
 2 State a shortage of organ and tissue donors to provide the organs
 
 3 and tissue that could save lives or enhance the quality of life
 
 4 for many persons.  There are many more patients on the waiting
 
 5 list for a kidney, liver, heart, lung, or other solid organs than
 
 6 there are donated organs.  As a result, many patients die before
 
 7 they can be given a second chance at life.
 
 8      The legislature further finds that increasing the chances of
 
 9 obtaining consent from more dying patients necessitates required
 
10 referrals of all deaths or near deaths to an organ procurement
 
11 organization.  Required referral means that the hospitals are
 
12 required to contact an organ procurement organization for every
 
13 death or near death without making an initial assessment of
 
14 medical suitability for organ donation.  The organ procurement
 
15 organization then works with the hospital to connect with the
 
16 affected family, make the request for donation and, if
 
17 appropriate, make the necessary arrangements for donation.  It
 
18 has been reported that since Pennsylvania adopted the required
 
19 referral law in 1995, an organ procurement organization serving
 
20 southeast Pennsylvania has had a forty per cent increase in organ
 
21 donation.
 
Page 2                                         197         
                                     H.B. NO.           
                                                        
                                                        

 
 1      The purpose of this Act is to increase the supply of organs
 
 2 for waiting transplant recipients.
 
 3      SECTION 2.  Chapter 327, Hawaii Revised Statutes, is amended
 
 4 by adding a new section to be appropriately designated and to
 
 5 read as follows:
 
 6      "�327-      Required referral.  (a)  On or immediately prior
 
 7 to the occurrence of a patient's death in an acute care hospital,
 
 8 the hospital shall contact an organ procurement organization to
 
 9 notify the organ procurement organization of the occurrence or
 
10 near occurrence of a patient's death.  This contact shall be
 
11 noted on the patient's medical record.
 
12      (b)  If at any time the hospital administrator or designee
 
13 receives actual notice of opposition from any of the persons
 
14 named in section 327-3 and the patient's organs have not yet been
 
15 removed for donation, the hospital and organ procurement
 
16 organization shall cease further action.
 
17      (c)  Within one year of the effective date of this Act, and
 
18 with the concurrence of the hospital medical staff, each acute
 
19 care hospital shall develop a protocol for identifying potential
 
20 organ, tissue, and eye donors.  The protocol shall require that
 
21 at or immediately prior to the time of every death, an acute care
 
22 hospital shall contact without delay a local organ procurement
 
23 organization to determine suitability for organ, tissue, and eye
 
24 donation.  Each hospital shall designate a person to contact the
 
25 organ procurement organization along with the appropriate data
 

 
Page 3                                         197         
                                     H.B. NO.           
                                                        
                                                        

 
 1 about the patient necessary to begin assessment for suitability
 
 2 for recovery of anatomical gifts.  The acute care hospital's
 
 3 protocol shall specify the kind of information that shall be
 
 4 available prior to making the contact, including but not limited
 
 5 to the patient's age and cause of death.
 
 6      (d)  The organ procurement organization in consultation with
 
 7 the patient's attending physician or designee shall determine the
 
 8 suitability for donation.  If the organ procurement organization
 
 9 in consultation with the patient's attending physician or
 
10 designee determines that:
 
11      (1)  The donation is not appropriate based on established
 
12           medical criteria, this shall be noted by the hospital
 
13           personnel on the patient's record, and no further
 
14           action shall be necessary; and
 
15      (2)  The patient is a suitable candidate for anatomical
 
16           donation, the acute care hospital and the organ
 
17           procurement organization, separately or together, shall
 
18           initiate a request by a designated requestor who shall
 
19           be a person trained by the organ procurement
 
20           organization.
 
21      The protocol shall encourage discretion and sensitivity to
 
22 family circumstances in all discussions regarding donations of
 
23 organs, tissue, or eyes.  The protocol shall take into account
 

 
Page 4                                         197         
                                     H.B. NO.           
                                                        
                                                        

 
 1 the patient's religious beliefs or nonsuitability for organ,
 
 2 tissue, or eye donation.
 
 3      (e)  The department of health shall conduct annual death
 
 4 record reviews at each acute care hospital to determine the
 
 5 hospital's compliance with this section.  The department may
 
 6 delegate its duty to conduct annual death record reviews to the
 
 7 local organ procurement organization.  There shall be no cost
 
 8 assessed against a hospital for a review of death records
 
 9 pursuant to this subsection.
 
10      (f)  The department of health may impose an administrative
 
11 fee of up to $500 for each instance of noncompliance.
 
12      (g)  For purposes of this section:
 
13      "Designated requestor" means a person who has completed a
 
14 course offered by an organ procurement organization on how to
 
15 approach families and request organ, tissue, or eye donation.    
 
16      "Noncompliance" means any failure on the part of an acute
 
17 care hospital to contact an organ procurement organization at or
 
18 immediately prior to the death of each patient."
 
19      SECTION 3.  New statutory material is underscored.
 
20      SECTION 4.  This Act shall take effect upon its approval.
 
21 
 
22                           INTRODUCED BY:  _______________________