House File 2389 - Introduced



                                       HOUSE FILE       
                                       BY  PETERSEN


    Passed House,  Date               Passed Senate, Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to the creation of a postnatal tissue and fluid
  2    banking network, and including the creation of an oversight
  3    commission.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  5 TLSB 5897YH 82
  6 pf/nh/5

PAG LIN



  1  1    Section 1.  NEW SECTION.  135O.1  DEFINITIONS.
  1  2    As used in this chapter, unless the context otherwise
  1  3 requires:
  1  4    1.  "Amniotic fluid" means the fluid inside the amnion.
  1  5    2.  "Birthing hospital" means a private or public hospital
  1  6 licensed pursuant to chapter 135B that has a licensed
  1  7 obstetric unit or is licensed to provide obstetric services.
  1  8    3.  "Commission" means the postnatal tissue and fluid
  1  9 banking oversight commission established pursuant to section
  1 10 135O.3.
  1 11    4.  "Cord blood" means human blood from the placenta and
  1 12 umbilical cord collected after the umbilical cord has been
  1 13 detached from the newborn child.
  1 14    5.  "Department" means the department of public health.
  1 15    6.  "Iowa hematopoietic stem cell bank" or "Iowa bank"
  1 16 means the Iowa hematopoietic stem cell bank of the university
  1 17 of Iowa hospitals and clinics.
  1 18    7.  "Placenta" means the organ that forms on the inner wall
  1 19 of the human uterus during pregnancy.
  1 20    8.  "Postnatal tissue and fluid" means the placenta,
  1 21 umbilical cord, and amniotic fluid expelled or extracted in
  1 22 connection with the birth of a child.
  1 23    9.  "Regional perinatal center" means a regional perinatal
  1 24 center established by the statewide perinatal care program.
  1 25    10.  "Statewide perinatal care program" means the statewide
  1 26 perinatal care program under the department of public health,
  1 27 that provides professional training, development of standards
  1 28 and guidelines of care, consultation to regional and primary
  1 29 providers, and evaluation of the quality of care delivered to
  1 30 reduce the mortality and morbidity of infants through a
  1 31 contract with the university of Iowa hospitals and clinics.
  1 32    11.  "Umbilical cord" means the gelatinous tissue and blood
  1 33 vessels connecting an unborn human being to the placenta.
  1 34    Sec. 2.  NEW SECTION.  135O.2  POSTNATAL TISSUE AND FLUID
  1 35 BANKING NETWORK.
  2  1    1.  The department shall establish a postnatal tissue and
  2  2 fluid banking network to collect, process, store, and provide
  2  3 for the disposition of stored specimens for therapeutic stem
  2  4 cell medical treatments and stem cell research.  The network
  2  5 shall include all of the following:
  2  6    a.  Birthing hospitals in the state as voluntary collection
  2  7 sites.
  2  8    b.  The Iowa hematopoietic stem cell bank, which shall be
  2  9 expanded, statewide, to provide for the testing of specimens
  2 10 collected to determine if the specimen is eligible for
  2 11 transplant or research.  Specimens eligible for research shall
  2 12 also be stored by the Iowa bank.
  2 13    c.  A partnership with a regional cord blood bank for
  2 14 storage of specimens determined to be eligible for
  2 15 transplantation and for entry of information regarding the
  2 16 specimens into appropriate national and international
  2 17 registries.
  2 18    2.  The Iowa hematopoietic stem cell bank shall provide
  2 19 birthing hospitals with training regarding the collection of
  2 20 postnatal tissue and fluids.  The Iowa bank shall offer
  2 21 participating birthing hospitals the option of collecting
  2 22 specimens for transportation to the Iowa bank via courier
  2 23 service.  Quality assurance shall be monitored by the
  2 24 statewide perinatal care program as part of regularly
  2 25 scheduled birthing hospital site visits.  Initially, specimen
  2 26 collection shall focus on the collection of cord blood.  At
  2 27 such time as other postnatal tissue or fluids are collected,
  2 28 procedures for collection shall be developed and organized
  2 29 through the regional perinatal centers as primary collection
  2 30 sites.  Training regarding the collection of these other
  2 31 postnatal tissue or fluids shall be provided to the regional
  2 32 perinatal centers by the Iowa bank and the regional perinatal
  2 33 centers shall in turn provide training to the birthing
  2 34 hospitals in their regions.
  2 35    3.  Birthing hospitals and health care providers shall
  3  1 promote and encourage the donation of postnatal tissue and
  3  2 fluid through education, public awareness, and the removal of
  3  3 barriers to donation.
  3  4    a.  Birthing hospitals and health care providers shall
  3  5 inform potential donors no later than the beginning of the
  3  6 third trimester of a pregnancy, of the options to donate to
  3  7 either private banking programs or to the Iowa bank.
  3  8    b.  Potential donors, at a minimum, shall be informed of
  3  9 all of the following:
  3 10    (1)  The current and potential future medical uses of
  3 11 postnatal tissue and fluids.
  3 12    (2)  The benefits and risks associated with postnatal
  3 13 tissue and fluid banking.
  3 14    (3)  Medical or family history criteria that may impact a
  3 15 family's consideration of postnatal tissue and fluid banking.
  3 16    (4)  An explanation of the differences between private and
  3 17 public banking.  Potential donors shall be informed that
  3 18 donated specimens may be purchased by companies for commercial
  3 19 use.
  3 20    (5)  Medically=accepted uses and benefits of postnatal
  3 21 tissue and fluid collection and transplantation.
  3 22    (6)  The costs associated with donation and storage, and an
  3 23 explanation of the storage, maintenance, and viability of
  3 24 transplantation of postnatal tissue and fluid.
  3 25    c.  Donation shall be promoted on a voluntary basis and
  3 26 birthing hospitals and providers shall work with the network
  3 27 to ensure that there is no cost to the donor for collection of
  3 28 donated specimens, unless the donation is a directed donation
  3 29 of cord blood to be stored for personal use.
  3 30    4.  The postnatal tissue and fluid banking network shall
  3 31 develop a state postnatal tissue and fluid bank database to
  3 32 maintain information regarding specimens collected and stored
  3 33 for the purposes of research.  The database shall utilize a
  3 34 web=based format, have the capacity to search multiple
  3 35 databases, deliver search results by encrypted electronic
  4  1 mail, maintain patient records, and generate reports for
  4  2 quality assurance and quality improvement purposes.
  4  3    5.  The postnatal tissue and fluid banking network shall
  4  4 partner with a regional cord blood bank for the purposes of
  4  5 providing specimens for transplantation and maintaining
  4  6 information regarding clinically useful cord blood specimens
  4  7 to link with national and international registries.  Following
  4  8 testing, specimens collected from birthing hospitals and
  4  9 health care providers in the state that are determined to be
  4 10 eligible for transplantation shall be sent to the regional
  4 11 cord blood bank for storage.  The partnership agreement shall
  4 12 require that the specimens sent to the regional blood bank
  4 13 shall be stored by the regional blood bank and that
  4 14 information regarding clinically useful cord blood specimens
  4 15 shall be maintained by the regional bank and also linked with
  4 16 and entered into appropriate national and international
  4 17 registries.  Specimens determined not eligible for
  4 18 transplantation shall be stored at the Iowa bank and made
  4 19 available for research.
  4 20    6.  Specimens collected shall not be used for creation of
  4 21 stem cells for reproductive cloning.
  4 22    7.  The postnatal tissue and fluid banking network shall
  4 23 comply and coordinate with all requirements for certification
  4 24 by all national and federal entities as specified by rule of
  4 25 the postnatal tissue and fluid banking oversight commission.
  4 26    8.  All research conducted by any member of the network
  4 27 shall be subject to approval of an institutional review board
  4 28 that is established in accordance with federal and state
  4 29 regulations.  Distribution of specimens for research shall
  4 30 also meet all rules adopted by the commission for such
  4 31 distribution.
  4 32    9.  The postnatal tissue and fluid banking network shall
  4 33 comply with all rules adopted by the commission including
  4 34 those related to consent, privacy, and the fee structure.
  4 35    Sec. 3.  NEW SECTION.  135O.3  POSTNATAL TISSUE AND FLUID
  5  1 BANKING OVERSIGHT COMMISSION.
  5  2    1.  The department shall convene and provide administrative
  5  3 support to a postnatal tissue and fluid banking oversight
  5  4 commission.
  5  5    2.  The commission shall consist of the following members,
  5  6 selected by the institution or association specified or, if
  5  7 not specified, selected by the director of public health:
  5  8    a.  The director of public health, or the director's
  5  9 designee.
  5 10    b.  A representative of each of the public and private
  5 11 colleges or universities in the state that have interest in
  5 12 postnatal tissue and fluid for the purposes of research or
  5 13 medical treatment.
  5 14    c.  A representative of the Iowa hospital association.
  5 15    d.  A representative of the Iowa osteopathic medical
  5 16 association.
  5 17    e.  A representative of the Iowa medical society.
  5 18    f.  A physician representing a birthing hospital.
  5 19    g.  A prenatal health care provider.
  5 20    h.  A representative of the Iowa midwives association.
  5 21    i.  A representative of the postnatal tissue and fluid
  5 22 research community.
  5 23    j.  A representative of recipients of postnatal tissue and
  5 24 fluid transplants.
  5 25    k.  A representative of a postnatal tissue and fluid
  5 26 transplant center.
  5 27    l.  A representative of a postnatal tissue and fluid bank.
  5 28    m.  An attorney with expertise in public health or
  5 29 biotechnology law, selected by the Iowa state bar association.
  5 30    n.  A recognized medical ethicist who has an accredited
  5 31 degree in medicine, medical ethics, or theology.
  5 32    3.  Members of the commission shall serve terms of three
  5 33 years, beginning and ending as provided in section 69.19.
  5 34 Vacancies shall be filled by the original appointing authority
  5 35 and in the manner of the original appointment.  Members shall
  6  1 receive reimbursement for actual expenses incurred while
  6  2 serving in their official capacity and may also be eligible to
  6  3 receive compensation as provided in section 7E.6.  A person
  6  4 appointed to fill a vacancy for a member shall serve only for
  6  5 the unexpired portion of the term.  A member is eligible for
  6  6 reappointment for two successive terms.
  6  7    4.  The commission shall meet at least quarterly and at the
  6  8 call of the chairperson.  A majority of the members
  6  9 constitutes a quorum.  Any action taken by the commission must
  6 10 be adopted by the affirmative vote of a majority of the
  6 11 members.
  6 12    5.  The commission shall do all of the following:
  6 13    a.  Develop regulations, protocols and policies, public
  6 14 reporting requirements, research requirements, and fiscal
  6 15 auditing and accountability measures relative to postnatal
  6 16 tissue and fluid banking in the state and in partnership with
  6 17 entities outside of the state with interest in postnatal
  6 18 tissue and fluid banking.
  6 19    b.  Establish an advisory council to address ongoing
  6 20 ethical, legal, and intellectual property issues.
  6 21    c.  Oversee the statewide expansion of the Iowa
  6 22 hematopoietic stem cell bank and the development of a
  6 23 partnership with an existing regional cord blood bank to
  6 24 maintain specimens eligible for transplantation.
  6 25    d.  Promote the development of a network of birthing
  6 26 hospitals in the state for the voluntary collection of cord
  6 27 blood and other postnatal tissue and fluids.
  6 28    e.  Develop criteria for the distribution of specimens for
  6 29 research and medical treatment.  Specimens shall be available
  6 30 to both private and public researchers.  Fees for research
  6 31 specimens shall be incurred by the research organization and
  6 32 shall be standard and comparable to the charges levied by
  6 33 similar tissue and fluid banks.
  6 34    f.  Provide for the collection of information regarding
  6 35 postnatal tissue and fluid banking specimens.  Information on
  7  1 clinically useful cord blood specimens shall be maintained by
  7  2 the regional cord blood bank with which the state partners to
  7  3 maintain specimens eligible for transplantation and to enter
  7  4 such specimens on national and international registries.  The
  7  5 state postnatal tissue and fluid bank database developed
  7  6 pursuant to section 135O.2, subsection 4, shall maintain
  7  7 information on specimens collected for the purpose of
  7  8 research.
  7  9    g.  Promote and encourage voluntary donation of postnatal
  7 10 tissue and fluid through education, public awareness, and the
  7 11 removal of barriers to donation.  To the extent possible, the
  7 12 commission shall seek approval to utilize existing educational
  7 13 and awareness materials as a basis for development of
  7 14 state=specific materials.
  7 15    h.  Provide for consent and privacy protections for persons
  7 16 who donate postnatal tissue and fluid.  The protections shall
  7 17 be consistent with applicable federal guidelines and shall
  7 18 address the collection, retention, use, and disposition of
  7 19 specimens, as well as ownership rights to the specimens.  The
  7 20 protections shall require that all specimens released for
  7 21 transplant or research shall not contain any identifying
  7 22 information upon release so as to protect from disclosure the
  7 23 identity of persons making donations to the state or regional
  7 24 bank.
  7 25    i.  Provide a fee structure for participation in the state
  7 26 postnatal tissue and fluid banking network.  The fee structure
  7 27 shall be based on the use of the specimen stored.  If the
  7 28 specimen is to be used for medical treatment, fees shall be
  7 29 imposed consistent with requirements of the regional bank.  If
  7 30 the specimen is used for research, fees shall be charged to
  7 31 the entity managing the research project.  Any costs incurred
  7 32 by the research entity to obtain institutional review board
  7 33 approval or to meet other requirements for project approval
  7 34 shall be the responsibility of the research entity.
  7 35    j.  Report to the governor and the general assembly in
  8  1 December, annually, concerning the activities of the network
  8  2 and the commission with recommendations for any legislative
  8  3 changes or funding necessary to fulfill the goals of this
  8  4 chapter.
  8  5    k.  Request additional funding from any additional source
  8  6 including but not limited to federal and private grants.
  8  7    l.  Review research request policies for consistency with
  8  8 other programs including but not limited to those policies
  8  9 established by the center for congenital and inherited
  8 10 disorders established pursuant to section 136A.3.
  8 11                           EXPLANATION
  8 12    This bill relates to postnatal tissue and fluid banking.
  8 13 The bill establishes a postnatal tissue and fluid banking
  8 14 network to collect, process, store, and provide for the
  8 15 disposition of stored specimens for therapeutic stem cell
  8 16 medical treatments and stem cell research.  The network
  8 17 includes birthing hospitals in the state as voluntary
  8 18 collection sites; the Iowa hematopoietic stem cell bank at the
  8 19 university of Iowa hospitals and clinics, which is to be
  8 20 expanded, statewide, to provide for the testing of specimens
  8 21 collected to determine if the specimen is eligible for
  8 22 transplant or research, with specimens eligible for research
  8 23 to also be stored by the Iowa bank; and a partnership with a
  8 24 regional blood bank for storage of specimens determined to be
  8 25 eligible for transplantation and for entry of information
  8 26 regarding these specimens into appropriate national and
  8 27 international registries.
  8 28    The bill directs the Iowa hematopoietic stem cell bank to
  8 29 provide birthing hospitals with training regarding collection
  8 30 of postnatal tissue and fluids.  Participating birthing
  8 31 hospitals may transport specimens collected to the Iowa bank
  8 32 via courier service.  Quality assurance is to be provided by
  8 33 the statewide perinatal care program.  Initially, specimen
  8 34 collection shall focus on collection of umbilical cord blood.
  8 35 At such time as other postnatal tissue or fluids are
  9  1 collected, procedures for collection shall be developed and
  9  2 organized through the regional perinatal centers as primary
  9  3 collection sites.
  9  4    The bill directs birthing hospitals and providers to
  9  5 promote and encourage the donation of postnatal tissue and
  9  6 fluid through education, public awareness, and the removal of
  9  7 barriers to donation.  The bill specifies information that, at
  9  8 a minimum, is to be provided to potential donors no later than
  9  9 the beginning of the third trimester of a pregnancy, regarding
  9 10 options to donate to either private banking programs or to the
  9 11 Iowa bank.  Donation is on a voluntary basis and birthing
  9 12 hospitals and providers are to work with the network to ensure
  9 13 that there is no cost to the donor for collection of donated
  9 14 specimens, unless the donation is a directed donation of cord
  9 15 blood to be stored for personal use.
  9 16    The bill directs the postnatal tissue and fluid banking
  9 17 network to develop a state postnatal tissue and fluid bank
  9 18 database to maintain information regarding specimens collected
  9 19 and stored for the purposes of research and to partner with a
  9 20 regional cord blood bank for the purposes of providing
  9 21 specimens for transplantation and maintaining information
  9 22 regarding clinically useful cord blood specimens to link with
  9 23 national and international registries.  The bill prohibits
  9 24 specimens collected from being used for creation of stem cells
  9 25 for reproductive cloning.
  9 26    All research conducted by any member of the network is
  9 27 subject to approval of an institutional review board, and
  9 28 distribution of specimens for research shall also meet all
  9 29 rules adopted by the postnatal tissue and fluids banking
  9 30 oversight commission for such distribution.
  9 31    The bill also directs the department of public health to
  9 32 convene and provide administrative support to a postnatal
  9 33 tissue and fluid banking oversight commission.  The bill
  9 34 specifies the membership of the commission, the terms of
  9 35 appointments, meetings of the commission, and other procedural
 10  1 requirements.  The duties of the commission include:
 10  2 developing regulations, protocols and policies, public
 10  3 reporting requirements, research requirements, and fiscal
 10  4 auditing and accountability measures relative to postnatal
 10  5 tissue and fluid banking in the state and in partnership with
 10  6 entities outside of the state with interest in postnatal
 10  7 tissue and fluid banking; establishing an advisory council to
 10  8 address ongoing ethical, legal, and intellectual property
 10  9 issues; overseeing the statewide expansion of the Iowa
 10 10 hematopoietic stem cell bank and the development of a
 10 11 partnership with an existing regional cord blood bank to
 10 12 maintain specimens eligible for transplantation; promoting the
 10 13 development of a network of birthing hospitals in the state
 10 14 for the voluntary collection of umbilical cord blood and other
 10 15 postnatal tissue and fluids; developing criteria for the
 10 16 distribution of specimens for research and medical treatment;
 10 17 providing for the collection of information regarding
 10 18 postnatal tissue and fluid banking specimens; promoting and
 10 19 encouraging voluntary donation of postnatal tissue and fluid
 10 20 through education, public awareness, and the removal of
 10 21 barriers to donation; providing for consent and privacy
 10 22 protections for persons who donate postnatal tissue and fluid;
 10 23 providing a fee structure for participation in the state
 10 24 postnatal tissue and fluid banking network; reporting to the
 10 25 governor and the general assembly annually; requesting
 10 26 additional funding from any additional source including but
 10 27 not limited to federal and private grants; and reviewing
 10 28 research request policies for consistency with other programs.
 10 29 LSB 5897YH 82
 10 30 pf/nh/5