THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY PETRARCA, OCTOBER 17, 2012

REFERRED TO COMMITTEE ON JUDICIARY, OCTOBER 17, 2012  

AN ACT

Amending Title 20 (Decedents, Estates and Fiduciaries) of the

Pennsylvania Consolidated Statutes, further providing for

definitions, for prospective donors, for prospective donees,

for procedure, for amendment or revocation, for rights and

duties at death, for requests, for identification and

authorization, for the Governor Robert P. Casey Memorial

Organ and Tissue Donation Awareness Trust Fund, for

confidentiality and for prohibitions; providing for promotion

of donations through a registry, for effect on advance health

care directive, for facilitation of gifts during

investigation, for collaboration, for information, for

physician and nurse training, for uniformity and for

electronic signatures; and further providing for corneal

transplants.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  The definitions of "advisory committee," "bank or

storage facility," "decedent" and "organ procurement

organization" in section 8601 of Title 20 of the Pennsylvania

Consolidated Statutes are amended and the section is amended by

adding definitions to read:

§ 8601.  Definitions.

The following words and phrases when used in this chapter

shall have the meanings given to them in this section unless the

context clearly indicates otherwise:

* * *

"Adult."  An individual who is at least 18 years of age.

"Advance health care directive."  As defined in section 5422

(relating to definitions).

"Advisory committee."  The Organ and Tissue Donation Advisory

Committee established under section 8622 (relating to The

Governor Robert P. Casey Memorial Organ and Tissue Donation

Awareness Trust Fund).

"Agent."  Any of the following:

(1)  An individual authorized to make health care

decisions on another's behalf under Subchapter C of Chapter

54 (relating to health care agents and representatives).

(2)  An individual expressly authorized to make an

anatomical gift on another's behalf by any other record

signed by the individual giving the authorization.

"Anatomical gift."  A donation of all or part of a human body

to take effect after the donor's death for the purpose of

transplantation, therapy, research or education.

["Bank or storage facility."  A facility licensed, accredited

or approved under the laws of any state for storage of human

bodies or parts thereof.]

* * *

"Decedent."  [A deceased individual, including a stillborn

infant or fetus.] A deceased individual whose body or part is or

may be the source of an anatomical gift. The term includes a

stillborn infant and, subject to restrictions imposed by other

laws, a fetus. The term does not include a blastocyst, embryo or

fetus that is the subject of an induced abortion.

"Document of gift."  A donor card or other record used to

make, amend or revoke an anatomical gift. The term includes a

statement or symbol on a driver's license or identification card

or in a donor registry.

"Donate Life PA Registry."  The registry established in

section 8625 (relating to promotion of organ and tissue

donation; Donate Life PA Registry established).

* * *

"Donor registry."  A database which contains records of

anatomical gifts. The term includes the Donate Life PA Registry.

"Eye bank."  A person that is licensed, accredited or

regulated under Federal or State law to engage in the recovery,

screening, testing, processing, storage or distribution of human

eyes or portions of human eyes.

* * *

"Hospital administrator."  Any individual appointed by a

hospital's governing body to act on its behalf in the overall

management of the hospital. The term includes a designee of the

individual.

"Know."  To have actual knowledge.

"Minor."  An individual who is under 18 years of age.

"Organ procurement organization."  An organization [that

meets the requirements of section 371 of the Public Health

Service Act (58 Stat. 682, 42 U.S.C. § 273)] designated for the

region by the Secretary of Health and Human Services as an organ

procurement organization.

* * *

"Person authorized or obligated to dispose of a decedent's

body."  Any of the following, without regard to order of

priority:

(1)  A coroner or medical examiner having jurisdiction

over the decedent's body.

(2)  A warden or director of a correctional facility

where the decedent was incarcerated.

(3)  An administrator or authorized official of a social

service agency having a relationship with the decedent.

(4)  An individual or official of an entity that:

(i)  is authorized to make decisions with respect to

the disposition, transportation, transfer, burial or

cremation of a decedent;

(ii)  is under an obligation to make decisions with

respect to the disposition, transportation, transfer,

burial or cremation of a decedent; or

(iii)  voluntarily assumes responsibility for

decisions with respect to the disposition,

transportation, transfer, burial or cremation of a

decedent.

* * *

"Program coordinator."  The Organ and Tissue Donation

Awareness Program Coordinator established in section 8622

(relating to The Governor Robert P. Casey Memorial Organ and

Tissue Donation Awareness Trust Fund).

"Prospective donor."  A person who is dead or whose death is

imminent and has been determined by an organ procurement

organization to have a part that could be medically suitable for

transplantation, therapy, research or education.

"Reasonably available."  Able to be contacted by a

procurement organization without undue effort and willing and

able to act in a timely manner consistent with existing medical

criteria necessary to make an anatomical gift.

"Recipient."  An individual into whose body a decedent's part

has been or is intended to be transplanted.

"Record."  Information that is inscribed on a tangible medium

or that is stored in an electronic or other medium and is

retrievable in perceivable form.

* * *

"Tissue bank."  A person that is licensed, accredited or

regulated under Federal or State law to engage in the recovery,

screening, testing, processing, storage or distribution of

tissue.

* * *

Section 2.  Sections 8611(a), (b) and (c) of Title 20 are

amended and the section is amended by adding a subsection to

read:

§ 8611.  Persons who may execute anatomical gift.

(a)  General rule.--Any individual of sound mind and 18 years

of age or more may give all or any part of his body for any

purpose specified in section 8612 (relating to persons who may

become donees; purposes for which anatomical gifts may be made),

the gift to take effect upon death. [Any] An agent [acting under

a power of attorney which authorizes the agent to make

anatomical gifts] may effectuate a gift for any purpose

specified in section 8612. Any individual who is a minor and 16

years of age or older may effectuate a gift for any purpose

specified in section 8612, provided parental or guardian consent

is deemed given. Parental or guardian consent shall be noted on

the minor's donor card, application for the donor's learner's

permit or driver's license or other document of gift. A gift of

the whole body shall be invalid unless made in writing at least

15 days prior to the date of death or consent is obtained from

the legal next of kin. Where there are adult children of the

deceased who are not children of the surviving spouse, their

consent shall also be required for a gift of the whole body for

anatomical study. A donor's gift of all or any part of the

individual's body, including a designation on a driver's license

or identification card, donor card, advance health care

directive, will or other document of gift, may not be revoked by

the next-of-kin or other persons identified in subsection (b).

The consent of any person at the time of the donor's death or

immediately thereafter shall not be necessary to render the gift

valid and effective.

(b)  Others entitled to donate anatomy of decedent.--Any of

the following persons who are reasonably available, in order of

priority stated, when persons in prior classes are not

reasonably available at the time of death, and in the absence of

[actual notice of contrary indications] known objections by the

decedent or [actual notice of opposition] by a member of [the

same or] a prior class, may give all or any part of the

decedent's body for any purpose specified in section 8612:

[(1)  The spouse.

(2)  An adult son or daughter.

(3)  Either parent.

(4)  An adult brother or sister.

(5)  A guardian of the person of the decedent at the time

of his death.

(6)  Any other person authorized or under obligation to

dispose of the body.]

(1)  An agent of the decedent at the time of death who

could have made an anatomical gift under subsection (a).

(2)  The spouse of the decedent.

(3)  An adult child of the decedent.

(4)  A parent of the decedent.

(5)  An adult sibling of the decedent.

(6)  A guardian of the person of the decedent.

(7)  An adult who is related to the decedent by blood,

marriage or adoption, including a stepparent, stepchild or

stepsibling.

(8)  A person that exhibited special care and concern for

the decedent.

(9)  A person authorized or obligated to dispose of the

decedent's body.

(b.1)  Others required to donate anatomy of decedent.--Unless

there is a known objection by the decedent, a hospital

administrator shall give all or part of the decedent's body for

any purpose specified in section 8612.

(c)  Donee not to accept in certain cases.--If the donee [has

actual notice of contrary indications] knows of an objection by

the decedent or that a gift by a member of a class is opposed by

a [member] reasonably available majority of the same class or a

reasonably available member of a prior class, the donee shall

not accept the gift. The persons authorized by subsection (b)

may make the gift after or immediately before death.

* * *

Section 2.1.  Section 8612 of Title 20 is amended to read:

§ 8612.  Persons who may become donees; purposes for which

anatomical gifts may be made.

[The following persons may become donees of gifts of bodies

or parts thereof for any of the purposes stated:

(1)  Any hospital, surgeon or physician for medical or

dental education, research, advancement of medical or dental

science, therapy or transplantation.

(2)  Any accredited medical or dental school, college or

university for education, research, advancement of medical or

dental science or therapy.

(3)  Any bank or storage facility for medical or dental

education, research, advancement of medical or dental

science, therapy or transplantation.

(4)  Any specified individual for therapy or

transplantation needed by him.

(5)  The board.]

(a)  Donees.--An anatomical gift may be made to any of the

following persons named in the document of gift:

(1)  If for research or education, any of the following:

(i)  A hospital.

(ii)  An accredited medical school, dental school,

college or university.

(iii)  The board.

(iv)  An organ procurement organization.

(v)  Any other appropriate person as authorized by

law.

(2)  Subject to subsection (b), an individual designated

by the person making the anatomical gift if the individual is

the recipient of the part.

(3)  An eye bank or tissue bank.

(4)  An organ procurement organization.

(b)  Directed donation.--If an anatomical gift to an

individual under subsection (a)(2) cannot be transplanted into

the individual, the part shall pass in accordance with

subsection (c) in the absence of a known objection by the person

making the anatomical gift.

(c)  Organ for transplant or therapy.--An anatomical gift of

an organ for transplantation or therapy, other than an

anatomical gift under subsection (a)(2), shall pass to the organ

procurement organization.

(d)  Default.--If the intended purpose or recipient of an

anatomical gift is not known, the following shall apply:

(1)  If the part is an eye, the gift shall pass to the

appropriate eye bank.

(2)  If the part is tissue, the gift shall pass to the

appropriate tissue bank.

(3)  If the part is an organ, the gift shall pass to the

appropriate organ procurement organization as custodian of

the organ.

(4)  If the gift is of the decedent's entire body, the

gift shall pass to the board.

(e)  Multiple purposes.--If there is more than one purpose of

an anatomical gift set forth in the document of gift but the

purposes are not set forth in any priority, the gift shall be

used for transplantation or therapy, if suitable, and shall pass

to the appropriate organ procurement organization. If the gift

cannot be used for transplantation or therapy, the gift may be

used for research or education.

(f)  Unspecified purpose.--If an anatomical gift is made in a

document of gift that does not name a person described in

subsection (a) and does not identify the purpose of the gift,

the gift may be used only for transplantation or therapy, and

the gift shall pass in accordance with subsection (d).

Section 2.2.  Section 8613(b), (d) and (e) of Title 20 are

amended and the section is amended by adding subsections to

read:

§ 8613.  Manner of executing anatomical gifts.

* * *

(b)  Gifts by other documents.--[A gift of all or part of the

body under section 8611(a) may also be made by document other

than a will.] An anatomical gift may be made by other document,

including by authorizing a statement or symbol indicating that

the donor has made an anatomical gift, which shall be recorded

in a donor registry or on the donor's driver's license or

identification card. The gift becomes effective upon the death

of the donor. The document, which may be a card designed to be

carried on the person, must be signed by the donor [in the

presence of two witnesses who must sign the document in his

presence]. If the donor is mentally competent to signify his

desire to sign the document but is physically unable to do so,

the document may be signed for him by another at his direction

and in his presence in the presence of two witnesses who must

sign the document in his presence. Delivery of the document of

gift during the donor's lifetime is not necessary to make the

gift valid. Revocation, suspension, expiration or cancellation

of a driver's license or identification card upon which an

anatomical gift is indicated does not invalidate the gift.

* * *

[(d)  Designation of person to carry out procedures.--

Notwithstanding section 8616(b) (relating to rights and duties

at death), the donor may designate in his will, card or other

document of gift the surgeon or physician to carry out the

appropriate procedures. In the absence of a designation or if

the designee is not available, the donee or other person

authorized to accept the gift may employ or authorize any

surgeon or physician for the purpose, or, in the case of a gift

of eyes, he may employ or authorize a person who is a funeral

director licensed by the State Board of Funeral Directors, an

eye bank technician or medical student, if the person has

successfully completed a course in eye enucleation approved by

the State Board of Medical Education and Licensure, or an eye

bank technician or medical student trained under a program in

the sterile technique for eye enucleation approved by the State

Board of Medical Education and Licensure to enucleate eyes for

an eye bank for the gift after certification of death by a

physician. A qualified funeral director, eye bank technician or

medical student acting in accordance with the terms of this

subsection shall not have any liability, civil or criminal, for

the eye enucleation.]

(d.1)  Reliance.--A person may rely on a document of gift or

amendment thereto as being valid unless that person knows that

it was not validly executed or was revoked.

(e)  Consent not necessary.--If a donor card, donor driver's

license, living will, durable power of attorney, donor registry

record or other document of gift evidencing a gift of organs or

tissue has been executed, consent of any person designated in

section 8611(b) at the time of the donor's death or immediately

thereafter is not necessary to render the gift valid and

effective.

* * *

(g)  Validity.--A document of gift is valid if executed in

accordance with:

(1)  this chapter;

(2)  the law of the state or country where it was

executed; or

(3)  the law of the state or country where, at the time

of execution of the document of gift, the person making the

anatomical gift:

(i)  is domiciled;

(ii)  has a place of residence; or

(iii)  is a citizen.

(h)  Choice of law.--If a document of gift is valid under

this section, the law of this Commonwealth governs

interpretation of the document.

Section 3.  Section 8615 of Title 20 is amended by adding

subsections to read:

§ 8615.  Amendment or revocation of gift.

* * *

(d)  Effectiveness of revocation.--A revocation made under

this chapter shall take effect if, before an incision has been

made to remove a part from the donor's body or before invasive

procedures have begun to prepare the recipient, the applicable

organ procurement organization, transplant hospital or physician

or technician knows of the revocation.

(e)  Revocation not a refusal.--A revocation made under this

chapter shall not be considered a known objection or refusal to

make a gift of one's body or parts nor a prohibition against a

person described in section 8611(b) (relating to persons who may

execute anatomical gift) making such a gift.

Section 4.  Sections 8616(b), (c) and (d), 8617, 8619, 8621,

8622, 8623 and 8624 of Title 20 are amended to read:

§ 8616.  Rights and duties at death.

* * *

(b)  Physicians.--The time of death shall be determined by a

physician who tends the donor at his death or, if none, the

physician who certifies the death. [The physician or person who

certifies death or any of his professional partners or

associates shall not participate in the procedures for removing

or transplanting a part.]

(c)  Certain liability limited.--A person who acts in good

faith in accordance with the terms of this subchapter or with

the anatomical gift laws of another state or a foreign country

is not liable for damages in any civil action or subject to

prosecution in any criminal proceeding for his act. Neither a

person making an anatomical gift nor a donor's estate shall be

liable for injury or damage which results from the making or use

of the anatomical gift. In determining whether an anatomical

gift has been made, amended or revoked under this chapter, a

person may rely upon representations of an individual listed in

section 8611(b) relating to the individual's relationship to the

donor or prospective donor unless the person knows that the

representation is untrue.

(d)  Law on autopsies applicable.--The provisions of this

subchapter are subject to the laws of this Commonwealth

prescribing powers and duties with respect to autopsies.

Notwithstanding 18 Pa.C.S. Ch. 91 (relating to criminal history

record information), an organ procurement organization is

authorized to obtain a copy of an autopsy report in a timely

fashion upon request and payment of reasonable copying fees.

§ 8617.  Requests for anatomical gifts.

[(a)  Procedure.--On or before the occurrence of each death

in an acute care general hospital, the hospital shall make

contact with the regional organ procurement organization in

order to determine the suitability for organ, tissue and eye

donation for any purpose specified under this subchapter. This

contact and the disposition shall be noted on the patient's

medical record.

(b)  Limitation.--If the hospital administrator or his

designee has received actual notice of opposition from any of

the persons named in section 8611(b) (relating to persons who

may execute anatomical gift) and the decedent was not in

possession of a validly executed donor card, the gift of all or

any part of the decedent's body shall not be requested.

(c)  Donor card.--Notwithstanding any provision of law to the

contrary, the intent of a decedent to participate in an organ

donor program as evidenced by the possession of a validly

executed donor card, donor driver's license, living will,

durable power of attorney or other document of gift shall not be

revoked by any member of any of the classes specified in section

8611(b).

(d)  Identification of potential donors.--Each acute care

general hospital shall develop within one year of the date of

final enactment of this section, with the concurrence of the

hospital medical staff, a protocol for identifying potential

organ and tissue donors. It shall require that, at or near the

time of every individual death, all acute care general hospitals

contact by telephone their regional organ procurement

organization to determine suitability for organ, tissue and eye

donation of the individual in question. The person designated by

the acute care general hospital to contact the organ procurement

organization shall have the following information available

prior to making the contact:

(1)  The patient's identifier number.

(2)  The patient's age.

(3)  The cause of death.

(4)  Any past medical history available.

The organ procurement organization, in consultation with the

patient's attending physician or his designee, shall determine

the suitability for donation. If the organ procurement

organization in consultation with the patient's attending

physician or his designee determines that donation is not

appropriate based on established medical criteria, this shall be

noted by hospital personnel on the patient's record, and no

further action is necessary. If the organ procurement

organization in consultation with the patient's attending

physician or his designee determines that the patient is a

suitable candidate for anatomical donation, the acute care

general hospital shall initiate a request by informing the

persons and following the procedure designated under section

8611(b) of the option to donate organs, tissues or eyes. The

person initiating the request shall be an organ procurement

organization representative or a designated requestor. The organ

procurement organization representative or designated requestor

shall ask persons pursuant to section 8611(b) whether the

deceased was an organ donor. If the person designated under

section 8611(b) does not know, then this person shall be

informed of the option to donate organs and tissues. The

protocol shall encourage discretion and sensitivity to family

circumstances in all discussions regarding donations of tissue

or organs. The protocol shall take into account the deceased

individual's religious beliefs or nonsuitability for organ and

tissue donation.

(e)  Tissue procurement.--

(1)  The first priority use for all tissue shall be

transplantation.

(2)  Upon Department of Health approval of guidelines

pursuant to subsection (f)(1)(ii), all acute care general

hospitals shall select at least one tissue procurement

provider. A hospital shall notify the regional organ

procurement organization of its choice of tissue procurement

providers. If a hospital chooses more than one tissue

procurement provider, it may specify a rotation of referrals

by the organ procurement organization to the designated

tissue procurement providers.

(3)  Until the Department of Health has approved

guidelines pursuant to subsection (f)(1)(ii), tissue

referrals at each hospital shall be rotated in a proportion

equal to the average rate of donors recovered among the

tissue procurement providers at that hospital during the two-

year period ending August 31, 1994.

(4)  The regional organ procurement organization, with

the assistance of tissue procurement providers, shall submit

an annual report to the General Assembly on the following:

(i)  The number of tissue donors.

(ii)  The number of tissue procurements for

transplantation.

(iii)  The number of tissue procurements recovered

for research by each tissue procurement provider

operating in this Commonwealth.

(f)  Guidelines.--

(1)  The Department of Health, in consultation with organ

procurement organizations, tissue procurement providers and

the Hospital Association of Pennsylvania, donor recipients

and family appointed pursuant to section 8622(c)(3) (relating

to The Governor Robert P. Casey Memorial Organ and Tissue

Donation Awareness Trust Fund) shall, within six months of

the effective date of this chapter, do all of the following:

(i)  Establish guidelines regarding efficient

procedures facilitating the delivery of anatomical gift

donations from receiving hospitals to procurement

providers.

(ii)  Develop guidelines to assist hospitals in the

selection and designation of tissue procurement

providers.

(2)  Each organ procurement organization and each tissue

procurement provider operating within this Commonwealth

shall, within six months of the effective date of this

chapter, file with the Department of Health, for public

review, its operating protocols.]

(a)  Procedure.--

(1)  A hospital located in this Commonwealth shall notify

the applicable designated organ procurement organization or a

third party designated by that organization of an individual

whose death is imminent or who has died in the hospital.

Notification shall be made in a timely manner to ensure that

examination, evaluation and ascertainment of donor status as

set forth in subsection (d) can be completed within a time

frame compatible with the donation of organs and tissues for

transplant. The notification shall be made without regard to

whether the person has executed an advance directive for

health care.

(2)  The following shall apply to coroners and medical

examiners:

(i)  Except as set forth in subparagraph (ii), a

coroner or medical examiner shall notify the applicable

designated organ procurement organization of a person's

death in accordance with a mutually agreed-upon protocol.

Notification shall be made in a timely manner to ensure

that examination, evaluation and ascertainment of donor

status as set forth in subsection (d) can be completed

within a time frame compatible with the recovery of

tissues for transplant.

(ii)  Notification under this paragraph shall not be

made if:

(A)  the decedent was admitted to the hospital at

or around the time of death; or

(B)  the notification to the coroner or medical

examiner occurred more than 18 hours following the

estimated time of the decedent's death.

(b)  Referrals.--If an organ procurement organization

receives a referral of an individual whose death is imminent or

who has died, the organ procurement organization shall make a

reasonable search of the records of the Donate Life PA Registry

or the applicable State donor registry that it knows exists for

the geographic area in which the individual resided or resides

in order to ascertain whether the individual has made an

anatomical gift.

(c)  Document of gift.--

(1)  If the referred patient has a document of gift,

including registration with the Donate Life PA Registry, the

procurement organization representative or the designated

requestor shall attempt to notify a person listed in section

8611(b) (relating to persons who may execute anatomical gift)

of the gift.

(2)  If no document of gift is known to the procurement

organization representative or the designated requestor, one

of these two individuals shall ask the persons listed in

section 8611(b) whether the decedent had a validly executed

document of gift. If there is no evidence of an anatomical

gift by the decedent, the procurement organization

representative or the designated requestor shall notify a

person listed in section 8611(b) of the option to donate

organs and tissues.

(3)  The hospital administrator or that person's

designated representative shall indicate in the medical

record of the decedent:

(i)  whether or not a document of gift is known to

exist or whether a gift was made; and

(ii)  the name of the person granting or refusing the

gift and that person's relationship to the decedent.

(d)  Testing.--

(1)  This subsection shall apply if:

(i)  a hospital refers an individual who is dead or

whose death is imminent to an organ procurement

organization; and

(ii)  the organ procurement organization determines,

based upon a medical record review, that the individual

may be a prospective donor.

(2)  If the requirements of paragraph (1) are met, the

following shall apply:

(i)  The organ procurement organization may conduct a

blood or tissue test or minimally invasive examination

which is reasonably necessary to evaluate the medical

suitability of a part that is or may be the subject of an

anatomical gift. Specific consent to testing or

examination under this subparagraph shall not be

required. The results of tests and examinations under

this subparagraph shall be used or disclosed only:

(A)  to evaluate medical suitability for donation

and to facilitate the donation process; and

(B)  as required or permitted by law.

(ii)  The hospital may not withdraw or withhold any

measures which are necessary to maintain the medical

suitability of the part until the organ procurement

organization has:

(A)  had the opportunity to advise the applicable

persons as set forth in section 8611(b) of the option

to make an anatomical gift and has received or been

denied authorization to proceed with recovery of the

part; or

(B)  has ascertained that the individual

expressed a known objection.

(e)  Testing after death.--After a donor's death, a person to

whom an anatomical gift may pass under section 8612 (relating to

persons who may become donees; purposes for which anatomical

gifts may be made) may conduct a test or examination which is

reasonably necessary to evaluate the medical suitability of the

body or part for its intended purpose.

(f)  Scope.--An examination conducted under this section may

include copying of records necessary to determine the medical

suitability of the body or part. This subsection includes

medical, dental and other health-related records.

(f.1)  Recipients.--

(1)  Subject to the provisions of this chapter, the

rights of the person to whom a part passes under section 8612

shall be superior to the rights of all others with respect to

the part. The person may accept or reject an anatomical gift

in whole or in part.

(2)  Subject to the terms of the document of gift and

this chapter, a person that accepts an anatomical gift of an

entire body may allow embalming, burial or cremation and the

use of remains in a funeral service. If the gift is of a

part, the person to whom the part passes under section 8612,

upon the death of the donor and before embalming, burial or

cremation, shall cause the part to be removed without

unnecessary mutilation.

(f.2)  Physicians.--

(1)  Neither the physician who attends the decedent at

death nor the physician who determines the time of the

decedent's death may participate in the procedures for

removing or transplanting a part from the decedent.

(2)  Subject to paragraph (1), a physician or technician

may remove a donated part from the body of a donor that the

physician or technician is qualified to remove.

(f.3)  Coordination of procurement and use.--

(1)  A hospital shall enter into agreements or

affiliations with organ procurement organizations for

coordination of procurement and use of anatomical gifts.

(2)  A person, including a coroner or medical examiner,

that seeks to facilitate the making of an anatomical gift for

the purposes of transplantation or therapy from a decedent

who was not a hospital patient at the time of death shall

notify the applicable designated organ procurement

organization at or around the time of the person's death in

order to allow that organization to evaluate the potential

donation and, if applicable, coordinate the donation process.

(g)  Death record review.--

(1)  The Department of Health shall make annual death

record reviews at acute care general hospitals to determine

their compliance with subsection (d).

(2)  To conduct a review of an acute care general

hospital, the following apply:

(i)  The [Department of Health] department shall

select to carry out the review the Commonwealth-licensed

organ procurement organization designated by the [Health

Care Financing Administration] Centers for Medicare and

Medicaid Services for the region within which the acute

care general hospital is located. For an organ

procurement organization to be selected under this

subparagraph, the organization must not operate nor have

an ownership interest in an entity which provides all of

the functions of a tissue procurement provider.

(ii)  If there is no valid selection under

subparagraph (i) or if the organization selected under

subparagraph (i) is unwilling to carry out the review,

the department shall select to carry out the review any

other Commonwealth-licensed organ procurement

organization. For an organ procurement organization to be

selected under this subparagraph, the organization must

not operate nor have an ownership interest in an entity

which provides all of the functions of a tissue

procurement provider.

(iii)  If there is no valid selection under

subparagraph (ii) or if the organization selected under

subparagraph (ii) is unwilling to carry out the review,

the department shall carry out the review using trained

department personnel.

(3)  There shall be no cost assessed against a hospital

for a review under this subsection.

(4)  If the department finds, on the basis of a review

under this subsection, that a hospital is not in compliance

with subsection (d), the department may impose an

administrative fine of up to $500 for each instance of

noncompliance. A fine under this paragraph is subject to 2

Pa.C.S. Ch. 5 Subch. A (relating to practice and procedure of

Commonwealth agencies) and Ch. 7 Subch. A (relating to

judicial review of Commonwealth agency action). Fines

collected under this paragraph shall be deposited into the

fund.

(5)  An organ procurement organization may, upon request

and payment of associated fees, obtain certified copies of

death records of a donor from the Division of Vital Records

of the department.

(h)  Definitions.--As used in this section, the following

words and phrases shall have the meanings given to them in this

subsection:

"Designated requestor."  A hospital employee completing a

course offered by [an] a designated organ procurement

organization on how to approach potential donor families and

request organ or tissue donation.

"Noncompliance."  Any failure on the part of a hospital to

contact an organ procurement organization as required under

subsection (d).

§ 8619.  Use of driver's license or identification card to

indicate organ or tissue donation.

(a)  General rule.--Beginning as soon as practicable, but no

later than January 1, 1995, or one year following the effective

date of this section, whichever is later, the Department of

Transportation shall redesign the driver's license and

identification card application system to process requests for

information regarding consent of the individual to organ or

tissue donation. The following question shall be asked:

Do you wish to have the organ donor designation printed

on your driver's license?

Only an affirmative response of an individual shall be noted on

the front of the driver's license or identification card and

shall clearly indicate the individual's intent to donate his

organs or tissue. A notation on an individual's driver's license

or identification card that he intends to donate his organs or

tissue is deemed sufficient to satisfy all requirements for

consent to organ or tissue donation. The department shall record

and store all organ donor designations in the Donate Life PA

Registry, regardless of whether a driver's license or

identification card is issued. The recorded and stored

designation is sufficient to satisfy all requirements for

consent to organ and tissue donation.

(b)  Electronic access.--The organ procurement organizations

designated by the Federal Government in the Commonwealth of

Pennsylvania as part of the nationwide organ procurement network

[may] shall be given 24-hour-a-day electronic access to

information necessary to confirm an individual's organ donor

status through the Department of Transportation's driver

licensing database. Necessary information shall include the

individual's name, address, date of birth, driver's license

number and organ donor status. Notwithstanding 75 Pa.C.S. § 6114 

(relating to limitation on sale, publication and disclosure of

records), the Department of Transportation is authorized to

provide the organ procurement organizations, after a written

agreement between the Department of Transportation and the organ

procurement organizations is first obtained, with the foregoing

information. The organ procurement organization shall not use

such information for any purpose other than to confirm an

individual's organ donor status at or near or after an

individual's death. The organ procurement organizations shall

not be assessed the fee for such information prescribed by 75

Pa.C.S. § 1955(a) (relating to information concerning drivers

and vehicles).

§ 8621.  The Governor Robert P. Casey Memorial Organ and Tissue

Donation Awareness Trust Fund contributions.

(a)  Driver's license.--Beginning as soon as practicable, but

no later than [January 1, 1995] July 1, 2013, the Department of

Transportation shall provide an applicant for an original or

renewal driver's license or identification card the opportunity

to make a contribution of [$1] $2 to the fund. The contribution

shall be added to the regular fee for an original or renewal

driver's license or identification card. One contribution may be

made for each issuance or renewal of a license or identification

card. Contributions shall be used exclusively for the purposes

set out in section 8622 (relating to The Governor Robert P.

Casey Memorial Organ and Tissue Donation Awareness Trust Fund).

The Department of Transportation shall monthly determine the

total amount designated under this section and shall report that

amount to the State Treasurer, who shall transfer that amount to

The Governor Robert P. Casey Memorial Organ and Tissue Donation

Awareness Trust Fund.

(b)  Vehicle registration.--The Department of Transportation

shall provide an applicant for a renewal vehicle registration

the opportunity to make a contribution of [$1] $2 to The

Governor Robert P. Casey Memorial Organ and Tissue Donation

Awareness Trust Fund. The contribution shall be added to the

regular fee for a renewal of a vehicle registration. One

contribution may be made for each renewal vehicle registration.

Contributions shall be used exclusively for the purposes

described in section 8622. The Department of Transportation

shall monthly determine the total amount designated under this

section and shall report that amount to the State Treasurer, who

shall transfer that amount to The Governor Robert P. Casey

Memorial Organ and Tissue Donation Awareness Trust Fund. The

Governor Robert P. Casey Memorial Organ and Tissue Donation

Awareness Trust Fund shall reimburse the department for the

initial costs incurred in the development and implementation of

the contribution program under this subsection in an amount of

not more than $375,000. The General Fund shall reimburse the

Department of Transportation for the actual annual operating

costs of the program for vehicle registrations as described in

this subsection [subject to the following limits: For the first

fiscal year during which this subsection is effective, the

General Fund shall reimburse the Department of Transportation

for the actual operating costs of the program in this subsection

up to a maximum of $100,000]. For each fiscal year thereafter,

the General Fund shall reimburse the Department of

Transportation for the actual operating costs of the program in

this subsection in an amount not to exceed the prior year's

actual operating costs on a full fiscal year basis plus 3%. The

amounts approved by the Governor as necessary are hereby

appropriated from the General Fund for this purpose.

(c)  Internet website.--Within one year of the effective date

of this subsection, the official Internet website of the

department shall provide links through which individuals may

make voluntary contributions of at least $1 to the fund,

electronically and by paper. The links shall be provided at

least in connection with the issuance of driver's licenses,

personal identification cards and registration of motor

vehicles.

§ 8622.  The Governor Robert P. Casey Memorial Organ and Tissue

Donation Awareness Trust Fund.

(a)  Establishment.--All contributions received by the

Department of Transportation under section 8621 (relating to The

Governor Robert P. Casey Memorial Organ and Tissue Donation

Awareness Trust Fund contributions) and the Department of

Revenue under section 8618 (relating to voluntary contribution

system) and the Department of Health under section 8617

(relating to requests for anatomical gifts) shall be deposited

into a special fund in the State Treasury to be known as The

Governor Robert P. Casey Memorial Organ and Tissue Donation

Awareness Trust Fund, which is hereby established.

(b)  Appropriation.--All moneys deposited in the fund and

interest which accrues from those funds are appropriated on a

continuing basis subject to the approval of the Governor to

compensate the Department of Transportation, the Department of

Health and the Department of Revenue for actual costs related to

implementation of this chapter, including all costs of the Organ

and Tissue Donation Advisory Committee created in subsection

(c). Any remaining funds are appropriated subject to the

approval of the Governor for the following purposes:

(1)  [10%] Ten percent of the total fund may be expended

annually by the Department of Health for reasonable hospital

and other medical expenses, funeral expenses and incidental

expenses incurred by the donor or donor's family in

connection with making [a vital organ donation] an organ or

tissue donation, along with programming, to provide support

services to organ and tissue donors and their families, such

as bereavement counseling services. Such expenditures shall

not exceed $3,000 per donor and shall only be made directly

to the funeral home, hospital or other service provider

related to the donation. No part of the fund shall be

transferred directly to the donor's family, next of kin or

estate. The advisory committee shall develop procedures,

including the development of a pilot program, necessary for

effectuating the purposes of this paragraph.

(2)  [50%] Fifty percent may be expended for grants to

certified organ procurement organizations for the development

and implementation of organ donation awareness programs in

this Commonwealth. The Department of Health shall develop and

administer this grant program, which is hereby established.

(3)  [15%] Fifteen percent may be expended by the

Department of Health, in cooperation with certified organ

procurement organizations, for the Project-Make-A-Choice

program, which shall include information pamphlets designed

by the Department of Health relating to organ donor awareness

and the laws regarding organ donation, public information and

public education about contributing to the fund when

obtaining or renewing a driver's license and when completing

a State individual income tax return form.

(4)  [25%] Twenty-five percent may be expended by the

Department of Education for the implementation of organ

donation awareness programs in the secondary schools in this

Commonwealth.

[(c)  Advisory committee.--The Organ Donation Advisory

Committee is hereby established, with membership as follows:

(1)  Two representatives of organ procurement

organizations.

(2)  Two representatives of tissue procurement providers.

(3)  Six members representative of organ, tissue and eye

recipients, families of recipients and families of donors.

(4)  Three representatives of acute care hospitals.

(5)  One representative of the Department of Health.

(6)  One representative of eye banks.

All members shall be appointed by the Governor. Appointments

shall be made in a manner that provides representation of the

northwest, north central, northeast, southwest, south central

and southeast regions of this Commonwealth. Members shall serve

five-year terms. The Governor may reappoint advisory committee

members for successive terms. Members of the advisory committee

shall remain in office until a successor is appointed and

qualified. If vacancies occur prior to completion of a term, the

Governor shall appoint another member in accordance with this

subsection to fill the unexpired term. The advisory committee

shall meet at least biannually to review progress in the area of

organ and tissue donation in this Commonwealth, recommend

education and awareness training programs, recommend priorities

in expenditures from the fund and advise the Secretary of Health

on matters relating to administration of the fund. The advisory

committee shall recommend legislation as it deems necessary to

fulfill the purposes of this chapter. The advisory committee

shall submit a report concerning its activities and progress to

the General Assembly within 30 days prior to the expiration of

each legislative session. The Department of Health shall

reimburse members of the advisory committee for all necessary

and reasonable travel and other expenses incurred in the

performance of their duties under this section.]

(c)  Advisory committee.--

(1)  The Organ and Tissue Donation Advisory Committee is

established. Membership shall be as follows:

(i)  The Secretary of Education or a designee.

(ii)  The Secretary of Health or a designee.

(iii)  The Secretary of Transportation or a designee.

(iv)  One representative from each designated organ

procurement organization.

(v)  Two representatives of tissue procurement

providers.

(vi)  Six members representative of:

(A)  organ, tissue and eye recipients;

(B)  families of recipients;

(C)  donors; and

(D)  families of donors.

(vii)  Two representatives of acute care hospitals

which are:

(A)  licensed in this Commonwealth; and

(B)  members of the Statewide association

representing the interests of hospitals throughout

this Commonwealth.

(viii)  One representative of eye banks.

(ix)  One representative of community health

organizations.

(2)  A member under paragraph (1)(i), (ii) and (iii)

shall serve ex officio.

(3)  For a member under paragraph (1)(iv), (v), (vi),

(vii), (viii) and (ix), the following apply:

(i)  Members shall be appointed in a manner which

reflects geographic diversity. Input on the selection of

the representatives under paragraph (1)(vii) shall be

sought from the Statewide association referred to in

paragraph (1)(vii)(B).

(ii)  The members shall serve five-year terms.

(iii)  The Governor may reappoint an advisory

committee member for successive terms.

(iv)  A member shall remain in office until a

successor is appointed and qualified.

(v)  If a vacancy occurs prior to completion of a

term, the Governor shall appoint a member to fill the

unexpired term in the same manner as the vacating member

was appointed.

(4)  The advisory committee shall meet at least

biannually to do all of the following:

(i)  Review progress in the area of organ and tissue

donation in this Commonwealth.

(ii)  Recommend education and awareness training

programs.

(iii)  Recommend priorities in expenditures from the

fund.

(iv)  Advise the Secretary of Health on matters

relating to administration of the fund.

(v)  Recommend legislation as necessary to fulfill

the purposes of this chapter.

(5)  The advisory committee shall submit a report

concerning its activities and progress to the Secretary of

the Senate and the Chief Clerk of the House of

Representatives by October 31 of each even-numbered year.

(6)  The Department of Health shall reimburse members of

the advisory committee only for necessary and reasonable

travel and other expenses incurred in the performance of

their duties under this subsection.

(d)  Reports.--The Department of Health, the Department of

Transportation and the Department of Education shall submit an

annual report to the General Assembly on expenditures of fund

moneys and any progress made in [reducing the number of

potential donors who were not identified] increasing the number

of donor designations.

[(e)  Definition.--As used in this section, the term "vital

organ" means a heart, lung, liver, kidney, pancreas, small

bowel, large bowel or stomach for the purpose of

transplantation.]

(f)  Lead Commonwealth agency.--

(1)  The Department of Health shall be the lead

Commonwealth agency responsible for promoting organ and

tissue donation in this Commonwealth and shall coordinate

activities among other collaborating Commonwealth agencies.

(2)  Within the Department of Health there is established

a full-time position of Organ and Tissue Donation Awareness

Program Coordinator.

(i)  The Department of Health shall be reimbursed by

The Governor Robert P. Casey Memorial Organ and Tissue

Donation Awareness Trust Fund for the actual cost of the

program coordinator position.

(ii)  The program coordinator has the following

powers and duties:

(A)  Assist in administration of the fund.

(B)  Serve as a full-time liaison to the advisory

committee and assist the advisory committee in

program development, projects, funding proposals and

priorities.

(C)  Serve as liaison with other Commonwealth

agencies. This clause shall include working with the

Department of Transportation to ensure that driver's

license centers promote organ and tissue donation and

comply with agreed-upon arrangements to display

information and materials.

(D)  Assist designated organ procurement

organizations in their collaborations with other

Commonwealth agencies.

§ 8623.  Confidentiality requirement.

The identity of the donor and of the recipient may not be

communicated unless expressly authorized by [the recipient and

next of kin of the decedent.]:

(1)  the recipient; and

(2)  if the donor is alive, the donor, or if the donor is

deceased, the next of kin of the donor.

§ 8624.  Prohibited activities.

[(a)  Affiliates.--No organ procurement organization selected

by the Department of Health under section 8617(g) (relating to

requests for anatomical gifts) to conduct annual death reviews

may use that review authority or any powers or privileges

granted thereby to coerce or attempt to coerce a hospital to

select the organization or any tissue procurement provider

contractually affiliated with the organization as a designated

tissue procurement provider under section 8617(e).

(b)  Unfair acts.--No organ procurement organization or

tissue procurement provider may disparage the services or

business of other procurement providers by false or misleading

representations of fact, engage in any other fraudulent conduct

to influence the selection by a hospital of a qualified tissue

procurement provider nor engage in unlawful competition or

discrimination. This subsection is not intended to restrict or

preclude any organ procurement organization or tissue

procurement provider from marketing or promoting its services in

the normal course of business.]

(a)  Procurement organizations.--

(1)  A procurement organization shall not do any of the

following:

(i)  Disparage the services or business of another

procurement organization by false or misleading

representations of fact.

(ii)  Engage in fraudulent conduct to influence the

selection by a hospital of a tissue bank or eye bank.

(iii)  Engage in unlawful competition or

discrimination.

(2)  This subsection is not intended to restrict or

preclude an organ procurement organization from marketing or

promoting its services in the normal course of business.

(b)  Funeral establishments.--

(1)  Except as set forth in paragraph (2), a funeral

director or a funeral establishment shall not:

(i)  remove body parts from a corpse;

(ii)  permit others to remove body parts from a

corpse; or

(iii)  use funeral establishment facilities to remove

body parts from a corpse.

(2)  Paragraph (1) shall not apply as follows:

(i)  Removal is permissible if it is:

(A)  necessary to perform embalming or other

services in preparation for burial or cremation; and

(B)  authorized in writing by a family member,

guardian or other person responsible for disposition

of the body.

(ii)  Notwithstanding any other provision of law, if

a donation is authorized under this chapter, a designated

organ procurement organization and a Pennsylvania

nonprofit eye bank accredited by the Eye Bank Association

of America may recover donated ocular tissue, including

the whole eye, cornea and sclera, and associated blood

specimens at a funeral establishment.

(3)  If a funeral director is notified by a person

authorized to make donations under this chapter that the

person wishes to donate body parts from a corpse within the

funeral director's custody, the funeral director shall

immediately notify the organ procurement organization

designated to serve that region.

Section 5.  Title 20 is amended by adding sections to read:

§ 8625.  Promotion of organ and tissue donation; Donate Life PA

Registry established.

(a)  Promotion.--The Department of Transportation shall

ensure access by residents of this Commonwealth to an Internet-

based interface which promotes organ and tissue donation and

enables residents 18 years of age or older who hold a

Pennsylvania driver's license or identification card to register

as donors and have their decisions immediately integrated into

the current database maintained by the department. The database

shall include only affirmative donation decisions.

(b)  Paper form.--

(1)  Within one year of the effective date of this

section, the department shall establish a system which allows

individuals who have been issued a driver's license or

identification card to add their donor designation to the

Donate Life PA Registry by submitting a form to the

department.

(2)  Registration shall be provided at no cost to the

registrant.

(c)  Donate Life PA Registry; name.--The database maintained

by the department for recording donor designations and Internet-

based interface established in this section shall be known as

the Donate Life PA Registry.

(d)  Form and content.--The form and content of the Internet-

based interface shall be maintained in collaboration with the

designated organ procurement organizations.

(e)  Effect.--

(1)  Donor information entered into the Donate Life PA

Registry shall supersede prior conflicting information:

(i)  provided to the Donate Life PA Registry;

(ii)  on the individual's physical driver's license

or identification card;

(iii)  on an advance health care directive;

(iv)  submitted under section 8611 (relating to

persons who may execute anatomical gift); or

(v)  submitted under any other statutory provision.

(2)  Registration by a donor shall constitute sufficient

authorization to donate organs and tissues for

transplantation and therapy. Authorization of another person

shall not be necessary to effectuate the anatomical gift.

(f)  Technology.--An information technology system adopted by

the Department of Transportation after the effective date of

this section shall continue to accommodate the inclusion of

donor designation information into the database and the ongoing

operation of the Donate Life PA Registry.

§ 8626.  Effect of anatomical gift on advance health care

directive.

(a)  Scope.--This section shall apply if a hospital patient

who is a prospective donor has executed an advance health care

directive or otherwise specified by record the circumstances

under which the patient would want life support withheld or

withdrawn, and the terms of the advance health care directive or

other record are in conflict with the option of making an