Assembly Committee – AB 497





Seventy-First Session

April 9, 2001


The Committee on Health and Human Serviceswas called to order at 1:30 p.m., on Monday, April 9, 2001.  Chairman Ellen Koivisto presided in Room 3138 of the Legislative Building, Carson City, Nevada.  Exhibit A is the Agenda.  Exhibit B is the Guest List.  All exhibits are available and on file at the Research Library of the Legislative Counsel Bureau.





Mrs.                     Ellen Koivisto, Chairman

Ms.                     Kathy McClain, Vice Chairman

Mrs.                     Sharron Angle

Ms.                     Merle Berman

Mrs.                     Dawn Gibbons

Ms.                     Sheila Leslie

Mr.                     Mark Manendo

Ms.                     Bonnie Parnell

Mrs.                     Debbie Smith

Mr.                     Wendell Williams




Mrs.                     Vivian Freeman

Ms.                     Sandra Tiffany




Assemblyman Joseph Dini, Jr., District 38

Assemblyman Dennis Nolan, District 13

Assemblyman Bob Beers, District 4

Assemblywoman Barbara Buckley, District 8







Marla McDade Williams, Committee Policy Analyst

Darlene Rubin, Committee Secretary




Steve Hanson, Deputy Fire Chief, Clark County Fire Department

Jim Spinello, Clark County

Rusty McAllister, Vice President, Professional Fire Fighters of Nevada

Gary Milliken, American Medical Response (AMR)

Bill Bradley, Nevada Trial Lawyers Association

Chris Ferrari, Regional Emergency Medical Services Authority (REMSA)

Jim Gubbels, Regional Emergency Medical Services Authority (REMSA)

Edrie LaVoie, Adoptive Parent

Peggy Pauley, Adoptive Parent

Wanda Scott, Department Child and Family Services (DCFS)

Elizabeth Breshears, Department of Child and Family Services

Frankie Sue Del Papa, Attorney General

Father Frank Murphy

Heidi Smith, Transplant Patient

Ginny Lewis, Deputy Director, Department of Motor Vehicles and Public Safety

Linda Bergstrom, Transplant patient

James Besson, Transplant patient

Ellen Beebee, Transplant patient

Paula Winne, Assembly Attaché

Debbie Pinjuv, Transplant Patient

Yvonne Sylva, Administrator, Department of Health


Note:  Simultaneous video conference in Room 4401 of the Grant Sawyer Office Building, 555 East Washington Avenue, Las Vegas, Nevada.


Assembly Bill 497:  Revises provisions relating to anatomical gifts. (BDR 40-1210)


Assemblywoman Dawn Gibbons, District 25, was accompanied by Attorney General Frankie Sue Del Papa, who had helped a great deal with the legislation and the issue of organ procurement and transplant.  Mrs. Gibbons reported she had worked with the Attorney General and other legislators, and various stakeholders to develop the amendment (Exhibit F) to A.B. 497.


Assemblywoman Gibbons advised that some in the audience were people who had had transplants and others were still waiting for transplants.  The bill, she said, was about making a gift of life to someone in need of an organ transplant and the bill would make that possible.


Attorney General Frankie Sue Del Papa expressed strong support for A.B. 497 and her strong commitment to help implement the legislation upon passage.  She also expressed her appreciation to Dawn Gibbons for bringing the legislation forward, and to the Department of Motor Vehicles and Public Safety for their extraordinary cooperation for the worthwhile endeavor.  She also thanked the recipients and others who appeared to share their stories.  Nearly everyone knew of someone who was waiting for, or who was a recipient of an organ.  The waiting was the hard part, she added.  Ms. Del Papa related a story of a woman whose husband was killed and who made the heroic decision to donate his organs; as a result 60 people were given life or helped in some way.


Ms. Del Papa said the Bureau of Consumer Protection named in the amendment was the right place to administer the bill’s anatomical gift account and the donor education program it would support.  A task force to make the bill’s goal a reality would begin there.  It was hoped that over the next interim the bill’s sponsors would work with the task force to come up with a five-year plan that   would have a continuing role for many different stakeholders.


Ms. Del Papa felt the Department of Motor Vehicles (DMV) was the best place to begin the education process and, for the small investment of time by DMV employees to hand out donor registry enrollment materials and the collection of a voluntary gift of $1 or more, the availability of transplantable organs would be significantly improved.  Nevada had approximately 1.4 million licensed drivers.  Out of that number, close to 300,000 have chosen to say “yes” to being a potential organ donor on their driver’s license.  The passage of A.B. 497 would do more to improve the gift of life.


Ms. Del Papa said that Senator Rawson had expressed support for the bill and planned to talk about getting people to register, because it sent a message that the person was serious about being a donor and wanted to be updated on what was happening in the field of organ donations.  Too often, she said, families were approached in emergency rooms and asked to donate, and that might have been the first time they heard of it.  She added that Assemblywoman Merle Berman had commended Assemblywoman Gibbons for her work and the strength of her commitment.  She said also that Assemblywoman Barbara Buckley had expressed support for the bill and wanted to share the following statistics:  in 1999, the number of organs recovered was 5.8 thousand from those who had died and 4.7 thousand from those still living.  That meant only 1 in 7 of the 70,000 people on the national waiting list got a chance at the gift of life.  Those numbers were unacceptably low.  Every day, according to the Living Bank, Houston, Texas, more than 12 people on the national waiting list died for lack of an organ.  The only organ procurement organization based in Nevada was the Nevada Donor Network, in Las Vegas, that served two transplant hospitals, Sunrise and University Medical Center, which only performed kidney transplants.  Nevada must rely upon organ procurement organizations that operated in Nevada and other states to meet the needs of Nevadans within the national system.  Washoe County and the Carson City area hospitals contracted with an organ procurement organization in California and Elko contracted with one in Utah.  Until Nevada was large enough to have its own full service transplant hospitals and procurement network it must make the best use of the existing system.  A.B. 497 would greatly improve Nevada’s participation numbers in those larger groups.


Ms. Del Papa said that Assemblywoman Chris Giunchigliani, who had expressed support, offered some additional statistics:  There were over 74,000 people waiting for an organ transplant in the country.  Most people who received the gift of life were living productive lives more than five years after their transplant surgery.


In closing, Ms. Del Papa thanked all the legislators who supported the bill, some of whom would be speaking, and she encouraged everyone to “step up to the plate” and become part of the program.


Next to speak, Assemblyman Bob Beers, District 4, said that since the meeting started four people had added their names to the national transplant waiting list; it was about 1 every 14 minutes.  He expressed support for A.B. 497 which he said was very important to insure that Nevadans had a fair opportunity of receiving the transplant organs they needed.  As of February 2001, people on the waiting list needed 47,000 kidneys, 17,000 livers, 1,000 pancreases, 4,000 hearts, 3,700 lungs, and a number of combinations thereof.


Assemblyman Dennis Nolan, District 13, spoke in support of the bill.  He related his first experience with transplants and donors was as a paramedic transporting the procurement teams from the airport to the hospital and back, and watching how fast they had to move when the jet was met at the airport.  Those team members talked of the patients waiting for organs and how the opportunity for saving their lives would be lost if they were not back with the organ in the shortest possible time.   That scenario occurred every day in Las Vegas, and frequently in northern Nevada as well.  Mr. Nolan also reported the case of a 6?year-old boy who was one of his hockey skaters who developed liver failure and was hospitalized.  The boy was frequently flown to UCLA Medical Center to await a transplant but something happened each time and the liver was not available and he would be flown back, each time getting closer to dying.  Finally, though, the family received a call that the liver was available he did receive the transplant.  The boy was now 13 and doing very well.  In closing, Mr. Nolan urged support for A.B. 497.


Assemblywoman Gibbons reported that Debbie Pinjuv received her liver transplant last session, the day that Assemblywoman Jan Evans’ bill was passed, in which Attorney General Del Papa and Mrs. Gibbons and Senator Rawson had asked Ms. Evans to include Nevadans first on organ transplants.


Next to speak was Debbie Pinjuv, who had last appeared before the committee in 1999, eight weeks before she received her liver transplant.  She said she could not recall what she said at that time and she remembered not being able to see very well as she was failing very quickly. Her doctor had told her husband she would not survive if she did not receive her liver in two weeks.  Three days later she received a call from Stanford that they had a liver for her. She said now, two years later, she was working, playing tennis, and feeling just fine.


Assemblyman Manendo told Mrs. Pinjuv the committee was glad she was here, that she looked wonderful, and not only was she playing tennis, she was playing politics.


Father Frank Murphy, the next speaker, said he had appeared before the committee two years earlier.  He represented the Transplant Network and had been very active in the interfaith movement in the Reno-Sparks area, mostly in the education of the church ministers and the synagogue rabbis to inform them of the importance of having their congregations consider the donation of their organs for the preservation of life.  He expressed support for the amendment brought forward by Assemblywoman Gibbons.


Father Murphy particularly supported the idea that the money that would be given would increase the educational programs.  He believed there was a vast need for education on the need for transplants.  As a theologian, he knew there were some believers and some churches that were opposed to transplants for religious reasons.  He thought that should be respected and be dealt with in such a way as those congregations would be able to understand the reasons for making that organ donation.  Father Murphy said one of the most important things in distributive justice was the respect of the donor; the wishes of the donor had to be respected.  Often the family had not respected an individual’s desire to be an organ donor when that desire was put on his driver’s license. The addition of the name of the person being placed on the National Register of Donors, and by meeting the condition that the donor’s family be notified of such a decision, should eliminate the unjust, unfair decisions made by family members which were contrary to the wishes of the person who wanted to be a donor.


Next to speak was Assemblywoman Barbara Buckley, District 8, who expressed strong support of the very worthwhile bill.  She said, too, that the previous witnesses and the statistics given in the testimony clearly showed the need for the bill.  She commended Assemblywoman Gibbons and Attorney General Del Papa for bringing attention to the important area of organ donation.


Heidi Smith, who had also appeared before the committee in 1999, said she had been on the transplant waiting list since 1996.  Since 1998 she had been at the top of the list where she remains today. One of the difficulties with waiting so long was that the body disintegrated around the problem.  As the body continued to fail it was patched up until a donor could finally be found.  She said she had been patched up so many times she felt like a “retread tire.”  She noted that anyone could need a transplant at any time, and it was important to get people to understand that and get on the donor program.


Virginia Lewis, Deputy Director, Department of Motor Vehicles and Public Safety, reported the department was very pleased to be part of the program and expand their role in increasing the number of participants.  The department asked their customers who came in for a driver’s license if they wanted to participate in the program, now they would be able to give them a brochure and an enrollment form.  That would be an educational service to the public and would improve what the department was doing.


Yvonne Sylva, Administrator, State Health Division, echoed other speakers in thanking Assemblywoman Gibbons for introducing the legislation, the Attorney General’s Office for supporting it, and every person who testified before the committee.  She said it was a “bill about living.”


Chairman Koivisto thanked Mrs. Gibbons for a good presentation.  She then noted that Larry Matheis, President, Nevada State Medical Association, had signed in support of A.B. 497, although he was not present to testify.  Attorney General Del Papa remarked that Mr. Matheis had participated in one of the work sessions to develop the bill and amendments and was an integral part of the process.


Next to speak was Linda Bergstrom, a recipient of a liver transplant three years earlier.  She reported being on the list for only six months but had been diagnosed with the disease in 1993.  She quickly deteriorated, having esophageal bleeding, stints, and kidney problems due to the liver failing.  She felt blessed to have received her liver in November 1997 and has felt very well ever since.  Had it not been for the transplant she would not have seen two children graduate from college or been present for the birth of her grandson.  She urged passage of A.B. 497.


James Besson reported he became ill in June 1996.  He was told he had one week to live when he received a liver transplant in June 1998.  He now played golf, went fishing, and worked, even though retired.  He said one of the major objections he had heard from others about being an organ donor was the expense involved in keeping someone on life support.  He asked that something be done to inform the public that was not necessarily true.


Chairman Koivisto responded that hopefully that would be part of the education portion of the legislation.


Assemblywoman Gibbons announced she would show a video of supporters for the bill as a backdrop to the testimony.  She was aided by attaché, Dawn Lee.


Ellen Beebee reported being on the waiting list for about eight years.  She had primary billiary cirrhosis, a slow progressing disease.  Her main problem was the itching involved, which she likened to poison ivy, day and night.  She had been on every drug without relief.  Her insurance coverage permitted her to go to Cal Pacific, however, because she could not get a liver transplant there, her doctor wanted her to go to the Mayo Clinic in Phoenix.


Assemblywoman Smith thanked the participants who worked on the bill and all those who came to testify.  She said someone close to her, in fact the person responsible for her being an assemblywoman, was waiting for a kidney.   It was an issue very important to her and it seemed that education and public awareness was the key to the program’s success.  She noted many reports and stories about people making a choice, and her own daughter, age 14, had announced she wanted to be a donor.


Assemblyman Manendo said he had made the choice to be an organ donor and was glad to see the DMV take on more responsibility in educating the public in that area.  He commended all the people and agencies that had worked on the bill.  He suggested making those brochures available in the student services areas of colleges.  The education was so necessary, he believed.


Chairman Koivisto asked the committee their wishes.



A.B. 497.




Marla McDade Williams, Committee Policy Analyst, brought to the committee’s attention some discussions before the meeting regarding subsection (d) of subsection 5 on page 3 of the proposed amendment, rather than saying that “the department shall periodically provide an organ and tissue donor registry with information from the department’s records as to the names, addresses, and births of donors contained in its records,” it would say something to the effect that “the department shall adopt procedures to periodically provide an organ and tissue donor registry with information from the department’s records.”







Assemblywoman Gibbons acknowledged and thanked the committee for its support through the entire process.




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