Existing law establishes the Office of Emergency Services within the office of the Governor, which is responsible for, among other things, the states emergency and disaster response services for specified disasters and emergencies.

This bill would authorize the Office of Emergency Services to enter into partnerships with private sector entities to encourage the private sector to provide meaningful incentives for individuals to make donations of human whole blood or human blood components.

Date of Hearing: April 19, 2023

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Chris Holden, Chair

ABPCA Bill Id:AB 813

Author:(Rodriguez) – As Introduced Ver:February 13, 2023

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill authorizes the Office of Emergency Services (OES) to enter into partnerships with private entities to encourage the private sector to provide meaningful incentives for individuals to donate blood four or more times a year to specified non-profit organizations.

FISCAL EFFECT:

Annual General Fund costs of approximately $478,000 to OES for two additional staff positions, including an individual with medical expertise given the subject matter, to develop and enter into memorandums of understanding with non-profit organizations to incentivize blood donation. While OES works with other state departments and private entities that encourage blood donation, OES itself is not a medical agency and would have to develop the relevant expertise prior to undertaking this work.

COMMENTS:

1. Purpose. According to the author, while the nationwide blood crisis “has mostly stabilized, the blood supply is always at risk of entering another shortage” which may result in otherwise preventable loss of life. The author “introduced this bill to expand California’s efforts to protect the blood supply.”
2. Incentives to Donate Blood. The American Red Cross, which historically provides about 40% of the nation’s blood supply, declared its first-ever nationwide blood crisis in January 2022. The blood shortage negatively affected hospitals and patients, forcing some delays in patient care. Several factors contributed to the shortage, including COVID-19 pandemic-related staffing limitations and cancelled donation drives.

Generally, people volunteer to donate blood to help others in need. However, nonprofit blood donation organizations also regularly provide incentives to recruit additional blood donors. For example, the American Red Cross offers $10 Visa gift cards and Vitalant has a system where donors can exchange points for gift cards and raffle tickets. This bill authorizes OES to partner with private entities to meaningfully incentivize blood donation.

1. Administering Agency. OES’s Office of Private Sector and Non-Governmental Organization Coordination designs, coordinates, and implements statewide outreach programs and works to maximize inclusion and effective use of private sector and non-governmental partnerships in all phases of emergency management. While the office could be tasked with leveraging private partnerships to incentivize blood donation, such efforts may be more intuitively led by a non-state entity already engaging in such work or a state entity already encouraging volunteer blood donation. For example, the California Department of Public Health’s Office of Communications has a “Give Blood, Save a Life” toolkit with social media images and messaging, including links to find a donation site and schedule an appointment, to urge more people to donate blood.
2. Prior Legislation. AB 1709 (Rodriguez), of the 2021-22 Legislative Session, contained a provision identical to this bill and would have also created a personal income tax credit of $500 if the taxpayer made at least four donations of blood to specified non-profit organizations. AB 1709 was heard for testimony only in the Committee on Revenue and Taxation.

Analysis Prepared by: Irene Ho / APPR. / (916) 319-2081

Date of Hearing: March 27, 2023

ASSEMBLY COMMITTEE ON EMERGENCY MANAGEMENT

Freddie Rodriguez, Chair

ABPCA Bill Id:AB 813 (

Author:Rodriguez) – As Introduced Ver:February 13, 2023

SUBJECT: Emergency services: blood donations

SUMMARY: This bill authorizes the Office of Emergency Services (Cal OES) to enter public-private partnerships for the purposes of incentivizing blood donations. Specifically, this bill:

1. Authorizes Cal OES to enter into partnerships with private sector entities to encourage the private sector to provide incentives for individuals to make donations of human whole blood or human blood components.

EXISTING LAW:

1. Establishes in state government, within the office of the Governor, Cal OES. (Government Code 8550)
2. Authorized Cal OES to provide guidance to business and nonprofit organizations on how to integrate private sector emergency preparedness measures into governmental disaster planning programs. (Government Code 8588.1)
3. Authorizes Cal OES to conduct outreach programs to encourage business to work with governments and community associations to better prepare the community and their employees to survive and recover from disasters. (Government Code 8588.1)
4. Requires Cal OES to establish a statewide donations system for private businesses and nonprofit organizations that are interested in donating services, goods, labor, equipment, resources, or dispensaries or other facilities (Government Code 8588.2)

FISCAL EFFECT: Unknown. A fiscal committee has not heard this bill.

COMMENTS:

Purpose of the bill: According to the author, “Last year, the American Red Cross declared its first-ever nationwide blood crisis. While that has mostly stabilized, the blood supply is always at risk of entering another shortage. It is alarming that California continues to reach crisis level in its blood supply, a position no one in an emergency should have to face. In the event of a disaster or large-scale emergency, a shortage of available blood may result in otherwise preventable loss of life. I have introduced this bill to expand California’s efforts to protect the blood supply. The solution is simple; those who can donate blood should and AB 1709 will incentivize donors to do so. The impact of a blood donation right now is immense. Allowing Cal OES to work with private partners to increase the number of donations through incentives will make a positive difference for our health care workers and those who are sick or injured.”

Equity Impact: According to the author’s staff, “Low income communities already experience additional barriers when accessing the healthcare system. Furthermore, 136 low income and rural area hospitals closed between 2010 and 2021 while many others now offer fewer services and beds in order to cut costs. With fewer options and less beds, blood supply shortages disproportionately affect poor and rural communities. This bill will incentivize additional donations and allow Cal OES to target areas that are most in need of blood.”

Blood Shortage: In early January 2022, the American Red Cross declared its first-ever nationwide blood crisis after it said the organization faced its worst blood shortage in over a decade. The Red Cross historically supplies about 40% of the nation's blood supply, but due to the shortage, some hospitals only received a quarter of the blood they needed. This issue was not unique to the American Red Cross as the nationwide number of blood donors at all donation sites decreased by roughly 10% between March of 2020 and January 2022.

The blood shortage negatively affected hospitals and patients across the state as doctors were forced to choose between who received care immediately and who waited until more blood became available. In more dire cases, hospitals were unable to treat anyone. For example, the Southern California based Harbor-U.C.L.A. Medical Center had to close their trauma center for two hours in early January 2022 because they exhausted their blood inventory. Furthermore, in the event of a disaster or large-scale emergency, a shortage of available blood could result in otherwise preventable loss of life.

Several factors contributed to the shortage, including canceled donation drives, staffing limitations, the COVID-19 pandemic, and active flu season. Additionally, the U.S. Food and Drug Administration’s donor eligibility restrictions based on sexual orientation artificially reduce the number of available donors. While the blood supply has stabilized throughout much of the United States, it is always vulnerable to shortages. Additionally, individual regions can still experience blood shortages. For example, in January of 2023, Vitalant – a nonprofit organization focused on blood services – reported their blood supply is about 20% below their pre-pandemic levels.

Existing Incentives: Nonprofit blood donation entities regularly provide incentives to recruit additional blood donors. For example, the American Red Cross is currently offering $10 Visa gift cards. Vitalant has implemented a points system where donors can exchange points for gift cards from various national retailers as well as raffling two $10,000 gift cards to individuals who donate blood in the month of March. Past incentives include raffles for tickets to major sport events – including the Super Bowl, movie tickets, admission to the State Fair, and raffles for various all expenses paid vacations.

Blood Donation Restrictions Related to HIV Risk: Up until 2015, the Food and Drug Administration (FDA) banned men who have sex with men (MSM) from donating blood for life. This rule was replaced to allow MSM to donate blood only if they were abstinent for a year. In 2020 – the same year blood donations severely decreased due to COVID-19 – the rule was once again changed to require MSM be abstinent for three months. In January 2023, the FDA proposed their latest round of guidelines to remove the time-based deferrals for MSM, revise the donor history questionnaire to ask all donors (not only MSM) about new or multiple sexual partners in the last 3 months, require donors who report a new sexual partner or multiple partners and had anal sex in the last 3 months be deferred from donating blood, and defers donors who take medications to prevent HIV from donating until the medications are no longer in their system. While these proposed rules slightly widen the eligible donations, MSM are still largely restricted from donating under these guidelines, including those who proactively take pre-exposure prophylaxis (PrEP) medication to prevent HIV in the first place. The rates of HIV in the MSM population have significantly decreased due to a wide adoption of PrEP. These guidelines still discriminate against homosexual men and prevent an entire community from donating blood.

Cal OES’s Office of Private Sector and Non-Governmental Organization: In 2015, Cal OES established the Office of Private Sector and Non-Governmental Organization (NGO) Coordination. This office designs, coordinates, and implements statewide outreach programs to foster relationships with businesses, associations, companies, academia, as well as non-profit and philanthropic organizations. It works within Cal OES to maximize inclusion and effective use of private sector and NGO staff and resources in all phases of emergency management.

Prior legislation:

AB 1709 (Rodriguez. 2022) This bill would have allowed, for taxable years beginning on or after January 1, 2023, a credit under the Personal Income Tax (PIT) Law equal to $500 if a taxpayer makes at least four blood donations in one year and authorized Cal OES to enter into partnerships with private sector entities to encourage the private sector to provide incentives for individuals to make donations of human whole blood or human blood components. (Died in Assembly Revenue and Taxation Committee)

AB 1568 (Committee on Emergency Management), Chapter 8, Statutes of 2022. This bill requires the California Office of Emergency Services (Cal OES) to establish a statewide donations system for private businesses and nonprofit organizations that are interested in donating services, goods, labor, equipment, resources, or facilities to assist in disaster preparedness.

AB 2796 (Nava), Chapter 363, Statutes of 2008. Authorizes Cal OES to establish a statewide registry of private businesses and nonprofit organizations that are interested in donating services, goods, labor, equipment, resources, or dispensaries or other facilities to further collaboration between the private and public sector.

SB 546 (Dutton), Chapter 232, Statutes of 2005. Authorizes OES to develop a program that promotes the collaboration between the public and private sector to better prepare for, respond to, and recover from disasters.

REGISTERED SUPPORT / OPPOSITION:

Support

None on file.

Opposition

None on file.

Analysis Prepared by: Ryan Fleming / E.M. / (916) 319-3802

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