Stem Cell Ethics Rules "Flawed"

The Center for Genetics and Society says that the recently adopted ethics standards of the California stem cell agency are "fundamentally flawed" and that its intellectual property rules are unlikely to come close to recouping the cost of the agency's program.

In its most recent newsletter, the center, a longtime critic of CIRM, says,

"While the research standards adopted by the governing board of the California Institute for Regenerative Medicine (CIRM) have some improvements in the details, the core of the policy remains inadequate. It leaves the approval of research protocols to local 'Stem Cell Research Oversight Committees' that will be formed by, and affiliated with, the institutions doing the research.

"These committees will consist largely of stem cell researchers themselves and their colleagues from related scientific fields, whose sympathies and loyalties are likely to lie with their institutions and with the research. Further, there will be no oversight of these committees, and key information will not be available to the public for scrutiny."

The center continued,

"The state's share of revenues under the new policy on intellectual property is unlikely to make a significant dent in the $6 billion cost of the program, and it is far from clear that this huge public investment in stem cell research is the best use of funds to promote the health of most Californians."

The center noted that the campaign for Prop. 71 promised that the program would pay for itself. Of course, those promises were based on a study that the campaign purchased.

The center's newsletter, Genetic Crossroads, provides a useful overview of recent events involving CIRM, including links to other coverage. But it includes many other topics as well. For example, the Feb. 23 edition includes research cloning, a recap of the latest developments in the Hwang affair, coverage of the Schatten case and other stories on related matters in this country and abroad. The newsletter is available by free electronic subscription.

CHI, Stem Cells, Love and Morrow

The California Healthcare Institute made some stem cell news this month with the appointment of a new director to its board and with the involvement of its chief counsel in an faith-based political flap.

CHI, a biomed industry group and supporter of the California stem cell agency, named Ted Love, chairman and CEO of Nuvelo Inc. of San Carlos, a biopharmaceutical firm, to the CHI board of directors. Love is also a member of the Oversight Committee of the California stem cell agency.

Earlier this month, CHI and stem cell research surfaced in a different way in the congressional campaign of Republican state Sen. Bill Morrow. His wife, Barbara, is vice president and general counsel of CHI.

Her connection to CHI became an issue, at least for some, because CHI supports embryonic stem cell research, something that Christian activists oppose.

According to the Agape Press web site, whose motto is "reliable news from a Christian source:

"Senator Morrow does not deny that his wife is employed at the Institute. But he claims her work as general counsel does not require her to promote the company's position on ESCR. The state lawmaker explains that his wife took the job after much prayer and consideration.

"'We sat down with pastors and nationally known bioethicists who were Christians and ministers ... before we accepted that position,' Senator Morrow says.

"Morrow states that he and his wife felt 'very comfortable' with the advice they received -- specifically, that it would clearly understood Mrs. Morrow would not be called on to lobby in support of ESCR. 'And under those conditions, which they've held up to, that's what she's done,' he adds."

Stem Cell Audit Proposal Delayed

Consideration of a proposal to have the legislature's auditor general examine the California stem cell agency has been put off until March 8 or later.

The office of Sen. Deborah Ortiz, who backed the audit along with a bipartisan group of 10 other legislators, announced the delay. No further explanation was offered.

$25 Million for Stem Cell Research and Other Stuff at USC

Funding for stem cell research in California received a big boost today from a self-made billionaire who is the son of Lithuanian immigrants.

The money -- $25 million – is going to USC to create the Broad Institute for Integrative Biology and Stem Cell Research. The institute will be named after Edythe and Eli Broad, who provided the funds through the Broad Foundation.

USC said the 215,000-square-foot facility will be the largest stem cell research center in California when it opens in 2008. The program will involve Childrens Hospital in Los Angeles and teams from Caltech and other regional scientific institutions.

Eighteen new investigators will be involved in the Center for Stem Cell and Regenerative Medicine and another 18 will be engaged in transplant biology, cardiovascular disease, diabetes and other metabolic diseases.

Broad co-founded the Kaufman and Broad home building firm and once owned SunAmerica insurance company, which he sold to AIG in 1998 for $18 billion, according to Forbes magazine. Broad was estimated to be worth $6 billion by Forbes.

Frankenstein, Train Wreck or Good Listener?

The Los Angeles Times has joined The Sacramento Bee in calling for more public disclosure of the financial interests of scientific advisors to the California stem cell agency.

In an editorial today, the Times said,

"One issue the institute still must confront is making the financial disclosures of its scientific advisors open to the public. These scientists will recommend which grant proposals should be approved, and it's important for the public to know that the reviewers, who often have links to companies and universities, will not be enriched by the advice they give.

"The agency's leaders argue that no worthwhile scientist would stand for such disclosure. But it's entirely reasonable — and increasingly common — to ask stem cell scientists to disclose their financial and research relationships. If a scientist wants to help decide how California spends $3 billion on stem cell research, he or she should be willing to take steps to assure the public that its money is being well spent."

The editorial generally lauded the agency, particularly the ethics and intellectual property rules approved earlier this month. But it added,

"It has taken more pressure from public interest groups than it should have to set the institute on the right path. That's probably because the governing board has no members from such groups, something the Legislature should correct once the three-year moratorium on amending Proposition 71 is over. Still, the board showed that it has learned how to listen and respond, one of its most promising steps so far."

On Sunday, the agency was likened to a Frankstein monster in an op-ed piece in the San Francisco Chronicle. Dana Welch, executive director of the Berkeley Center for Law, Business and the Economy, posed a series of questions about the agency, ranging from the direction of CIRM's priorities to IP rights.

"Prop 71 left these questions and more wide open. Answer any one wrong, or leave them to chance, and we risk a South-Korean-like train wreck, potentially setting back by years the development of potential cures. Answer these questions right, and California becomes a model for other states and countries conducting stem cell research," she wrote.

The questions raised by Welch are identical to the ones being discussed at a conference early in March at Boalt Hall in Berkeley. Her group is one of the sponsors.

Ortiz Seeks Performance Audit of CIRM; Westly Says "Tough Oversight" Needed

Acting on a suggestion of Gov. Schwarzenegger, California State Sen. Deborah Ortiz and nine other legislators are calling for a performance audit of the California stem cell agency.

Their request will come before the Joint Legislative Audit Committee on Wednesday at 1:30 p.m. in room 447 of the state Capitol.

In the letter calling for the audit, Ortiz, a Sacramento Democrat, said the review should include:

"...the strategic policies and plans developed by the CIRM and the ICOC; policies and procedures for issuance of research and facility contracts and grants; policies for hiring and compensation of staff and for procurement of goods and services; policies for managing conflicts of interest for ICOC and working group members; and policies and procedures relating to management of intellectual property rights associated with research funded or commissioned by the CIRM."

She noted that a performance audit of CIRM would have been required by her legislation (SB18) that was vetoed by the governor. She said the governor's veto message urges the legislature to pursue an audit through the Joint Legislative Audit Committee.

Ortiz' request, which includes support from three Republican legislators, calls for completion of the audit by Sept. 30. Her office did not issue a press release on her Feb. 1 request letter. We asked for it after discovering the item on the agenda of the Audit Committee.

CIRM also faces an audit of its own that will cost about $50,000 and be performed by the firm of Gilbert Associates of Sacramento. But the one requested by Ortiz is likely to be the most rigorous.

State Controller Steve Westly, who is seeking the Democratic nomination for governor, announced last week he would be reviewing CIRM's financial activities. Westly's campaign is making a special effort, fueled by Google ads, to "get stem cell research back on track now."

As state controller, Westly is also chair of the Financial Accountability and Oversight Committee of CIRM and is required by law to "review" CIRM's own audit annually and issue a public report.

In a little noticed press release last week, Westly described himself as a strong supporter of Prop. 71 and said, “Tough oversight will ensure the public's confidence in our stem cell program. The stakes are too high for the institute to risk its funds or the public's trust.”

Westly's office will review the audit already commissioned by CIRM and discuss it a meeting of the Financial Accountability Committee later this spring.

In addition to himself, Westly announced that following the following persons are on the committee:

"Richard Siegal, member, appointed by the State Controller
"John Hein, appointed by the Assembly Speaker
"Jim Lott, appointed by the Senate President Pro Tem
"Daniel S. Brunner, appointed by the State Treasurer
"Myrtle Potter, member, appointed by the Chair of the Independent Citizen's Oversight Committee"

No further information was provided in Westly's press release about the qualifications of the five persons.

A copy of Ortiz' letter follows below because it was not available online at the time this writing.

Ortiz's Audit Request Letter

Here is a copy of Sen. Ortiz' audit request letter.

February 1, 2006

Assemblymember Nicole Parra
Chair, Joint Legislative Audit Committee
State Capitol, Room 4005
Sacramento, CA 95814

Dear Assemblymember Parra:

We are writing to request that the State Auditor conduct a performance audit of the California Institute for Regenerative Medicine (CIRM) created by Proposition 71, the California Stem Cell Research and Cures Act, in November, 2004, and to report the results of the audit by September 30, 2006.

We believe a performance audit of the CIRM and the Independent Citizen’s Oversight Committee (ICOC) which governs it would be of great value in guiding the implementation of this large new state program and ensuring that taxpayers’ funds in this area are well spent. Among other things, we would recommend that the audit review the strategic policies and plans developed by the CIRM and the ICOC; policies and procedures for issuance of research and facility contracts and grants; policies for hiring and compensation of staff and for procurement of goods and services; policies for managing conflicts of interest for ICOC and working group members; and policies and procedures relating to management of intellectual property rights associated with research funded or commissioned by the CIRM.

As has been widely reported, the initial implementation of this important new program has been hampered by a number of problems. Due to litigation, the CIRM has not been able to issue bonds to commence making research and facility grants. As a result, the program has relied on loans from private individuals and may soon begin issuing bonds that are not backed by a payment guarantee by the state. In addition, a number of CIRMs hiring, compensation, and contracting actions and expenditures have been questioned as being excessive. Finally, many reviewers have questioned the criteria used to select a site for the CIRMs administrative offices.

SB 18 (Ortiz and Runner) of the 2005-06 Session would have required the State Auditor to conduct a performance audit of the CIRM and the ICOC and to provide the audit report to the Legislature on or before June 30, 2006. It would also have required the State Auditor, on or before October 2007, to provide an analysis of the CIRMs implementation of the recommendations contained in the audit report.

In his veto message, the Governor stated he was vetoing the measure due to concerns that these provisions constituted an impermissible legislative amendment of Proposition 71, which provides that its provisions may be amended by the Legislature in furtherance of its purposes no earlier than the third full calendar year following its adoption by 70 percent of the membership of both houses or the Legislature. The veto message urges the Legislature to pursue a performance audit of the CIRM through the Joint Legislative Audit Committee. Accordingly, through this letter we are requesting that JLAC commission a performance audit of CIRM and the ICOC.

Thank you for your attention to this request. If you have any questions regarding the request, please feel free to contact us or our staffs.

Sincerely,



_
SENATOR DEBORAH ORTIZ, SENATOR GEORGE RUNNER, SENATOR LIZ FIGUEROA, SENATOR SHEILA KUEHL, SENATOR ABEL MALDONADO, SENATOR RICHARD ALARCÓN, SENATOR GLORIA ROMERO, SENATOR ROBERT DUTTON, SENATOR JACK SCOTT, ASSEMBLYMEMBER WILMA CHAN, ASSEMBLYMEMBER JACKIE GOLDBERG

Major Stem Cell Conference Scheduled for March 2-4 at UC Berkeley

Another major stem cell conference is scheduled for March in Bay Area. This one is is being held March 2-4 at UC Berkeley's Boalt Hall and is called "California's Stem Cell Initiative: Confronting the Legal and Policy Challenges."

The 2 ½-day conference has a host of speakers ranging from Ed Penhoet, vice chair of the California stem cell agency, to California state Sen. Deborah Ortiz, who is carrying legislation to step up oversight of the agency. Scientists, academicians, economists and more are scheduled to appear.

You can register at this link. The cost ranges from a $350 corporate level to $25 for students. You can access a fine bibliography of articles by speakers at the conference by clicking here. The other March conference is sponsored by Burrill and Company, a San Francisco life sciences merchant bank. Registration fees are $1495 for that meeting. You can read our earlier item on it here.

Clashing Interests on the Stem Cell Oversight Committee

It happened so quickly that only a keen-eyed parliamentarian might have noticed.

One minute the Oversight Committee of the California stem cell agency had a quorum. The next minute it didn't. It was late in the day last Friday. Some members had already left. Then two more members left the room, after expressing displeasure about procedures to create a long overdue strategic plan on how to spend $3 billion. That stymied a vote on the proposal.

"I am extraordinarily disappointed," said Oversight Committee member Claire Pomeroy, dean of the UC Davis Medical School, "that we are not going to have a quorum. We have not carried through on our responsibilities." Her comments came well after the departure of the two other committee members.

On the surface, the matter seems minor – planning a plan, what could be more picayune? But the real stakes – broadly speaking – pit the priorities of the patient advocates against the academic contingent on the board The patient advocates – 10 out of 29 persons on the committee -- represent groups of persons who have diseases that could benefit from stem cell therapies. Generally, the advocates emphasize great speed in bringing cures to the marketplace. The academicians on the board stress thorough science and warn that it is a slow process.

Serving as backdrop to their issues is the Korean stem cell scandal. Some say the focus on speed was one of the causes leading to the fraud.

On Friday, the plan for the strategic plan was carefully laid out by CIRM President Zach Hall. He said it would be a $500,000 effort, conducted by CIRM staff and brought to the board for approval and changes in the summer of 2006. Hall said Price Waterhouse Coopers would be chosen to assist in devising the plan. Overseeing the effort would be a relatively small subcommittee of Oversight members, selected by Hall.

It was the nature of subcommittee that triggered the objections of the two board members, David Serrano-Sewell and Jeff Sheehy, who walked out of the meeting. Serrano-Sewell said he said he was uncomfortable with the subcommittee and not knowing who would be on it. Sheehy echoed his concern. Their objections were relatively brief compared to the hours-long discussion of the planning process at December's Oversight meeting.

One of the issues complicating the process of coming up with a plan is a state law that requires the public to be notified well in advance of meetings by public bodies.

Hall's plan would avoid much of the time-consuming process by minimizing the number of required public meetings. It would also make it easier to call meetings of the public subcommittee. A smaller group means fewer schedule conflicts when setting up sessions. Hall did indicate that he did not want to short-change the public in terms of its opportunity to make its voices heard.

Representatives from academic institutions praised Hall's plan at Friday's meeting, noting that it was similar to the way their organizations operated. In other words, charging the staff to develop the proposal and bring to it the full board for changes and approval.

But Joan Samuelson, a patient advocate, said the strategic plan was very important and that the board was going to have to "own" it. She later told us that the patient advocates wanted to be very involved in planning and said that others seemed more worried about complying with open meeting laws than the stem cell research.

The discussion of the issue at Friday's meeting was relatively brief. To catch a better flavor of the positions here are a few excerpts from December's Oversight Committee meeting, which unveiled many concerns.

Jonathan Shestack, founder and president of Cure Autism Now:

"The motion that you have before you is a recipe for no board involvement in the strategic planning. Yes, it is. It makes that possibility very real. it makes all input be at will of staff except for presentation at the ICOC meetings. These are large, fairly unwieldy meetings....I don't mean to be negative about the staff because they are expert and fantastic, and we depend on them, but there is right now no real mechanism on the strategic decisions for the various communities to participate, particularly advocacy and particularly industry. And I think that just giving the full duty to staff and saying present it to us once in a while, and we'll tell you what we think is not to get into the detail that some people would want."

David Serrano-Sewell, representing the
Amyotrophic Lateral Sclerosis Association and National Multiple Sclerosis Society

"Commitments from the office of the (CIRM)president...just putting it in one individual -- for me, right now --is not enough. (During) my conversations with my appointing officer (the person who appointed Sewell to the CIRM board), there was a real commitment that we do a good job to represent our constituencies. and for me that's MS and ALS".

Shestack

"I also think there is a danger when all the positions -- academic, advocacy, industry -- are not talking to each other, talking only to a central person who then filters their needs."

Gerald Levey, dean of the UCLA Medical School

"I would hope that the board is not so balkanized that we think about who we represent and how we got here. i think now that we're a board, we're supposed to be thinking like we all have the same goal, the same purpose. and I would hope that the goal is to further stem cell research in the state of California -- not whether academia is being served better in the process or industry or what have you. So i hope that we don't get into a situation where we have us against them on the board."

"The matter of the plan concluded at Friday's meeting with discussion of another plan to hold a conference-call meeting in the next few weeks of the Oversight Committee to vote on Hall's plan for the plan

."

One final note: Nineteen members of the 29-member Oversight Committee are required for a quorum. Otherwise, the board cannot take legal action.

Human Tidbits Amid Stem Cell Policy

The California Stem Cell Report spends most of its time blathering about policy issues involving the California stem cell agency. Good grits for wonks. But there is another view. I just took a quick look at Don Reed's blog, stemcellbattles.com, and his report on last Friday's meeting of the Oversight Committee meeting. He focused on the "spotlight" on diabetes prior to the actual meeting. Nice, human touches and tidbits about the people and players you won't read elsewhere.

Valentine's Day Editorials on CIRM

Two California newspapers came out with editorials today praising actions last week by the California stem cell agency. It is only coincidental that the pieces appeared on Valentine's Day. The critics still want more.

The Sacramento Bee, one of the stronger critics of CIRM, said.

"On Friday, Klein and the oversight committee took a big step toward reversing past mistakes and demonstrating they can operate as an open, responsive public body. After listening to public interest groups, ethicists and legislators, the 29-member committee approved policies on medical standards and commercial licensing of stem cell therapies that, while not perfect, are a vast improvement over where the institute was heading just a few months ago."

But it also wrote,

"For the last several months, the institute has refused to make public the economic disclosure forms filed by out-of-state scientists who will recommend millions of dollars in research grants. The public deserves to know if these advisers have ties to companies and researchers applying for public monies. Since scientists regularly disclose their potential conflicts when publishing or presenting their work, there is no reason they cannot do so while making key decisions on taxpayer-funded grants."

The San Jose Mercury News also praised the egg and royalty sharing policies adopted last week by CIRM.

The Foundation for Taxpayer and Consumer Rights hitched a bit of a ride too on the Valentine Day bandwagon, lauding the actions as moving in the right direction.

But it urged more royalty money for the state, tougher enforcement mechanisms to assure low prices on therapies and creation of a stem cell patent pool to share information on CIRM-funded inventions.

"Certainly companies should make a fair profit on drugs they develop based on Proposition 71-funded research. But they must not be allowed to benefit unreasonably at the public's expense. The Attorney General should have the right to intervene -- 'march-in rights' -- in the event of unreasonable pricing," said John M. Simpson, stem cell project director for the foundation in a letter to CIRM Chairman Robert Klein.

We should also note the piece by Marisa Lagos of the San Francisco Examiner on last Friday's meeting. It pointed out that the CIRM regulations could become a model for the nation.

Reader's Write

The following email came in from John M. Simpson, stem cell project director of the Foundation for Taxpayer and Consumer Rights, regarding our "What's in a Name?" item.

"I liked your astute analysis of the naming rights issue.

"I agree that in a perfect world it wouldn’t happen, but given CIRM’s circumstances the institute probably needs the money.

"The ICOC will have to screen potential donors to make sure there are no outrageous or inappropriate contributions. That’s why the board is there.

"All the transactions must be completely transparent and organizations like the Foundation for Taxpayer and Consumer Rights will continue to monitor ICOC activities to ensure no abuses occur."

We encourage comments, favorable or unfavorable, or even insightful and enlightening. You can post them directly or anonymously by clicking on the word "comment" below each item. Or you can send them to djensen@californiastemcellreport.com.

Egg Irony

LifeNews.com is a Web site adamantly opposed to embryonic stem cell research. It is describes itself as an enterprise that reaches 150,000 pro-life advocates each week through various means.

So it comes as a bit of a shock to see ads on at least one of its Web pages soliciting egg donors. One of the ad sites, Loving Donation, says it pays its egg donors a minimum of $3,000 with high demand donors commanding higher fees. The ads are placed on LifeNews.com pages automatically by Google so LifeNews.com has no direct control over them. It is also unclear whether any of the fertility clinics that advertise also supply excess eggs for research purposes.

The Google ads change regularly on Web pages so there is no guarantee that you will find them there in just the same way. But here is the link to the page where we saw them.

What's in a Name? Ten Million Dollars or More

California is not likely to see something called the Pfizer/CIRM Research Scholars Program, but the stem cell agency is on its way to peddling naming rights in the world's largest stem cell research effort.

Peddling probably is not the most generous way to describe the effort, which seems to be an essential ingredient in assuring funding of programs this year. A more euphemistic way to say it would be: Providing an incentive to make a $10 million gift to CIRM.

The Oversight Committee moved forward with the program last week after stem cell chairman Robert Klein said it would apply only to grants of $10 million or more. Naming rights would not be available to purchasers of bond anticipation notes.

Initial screening of the naming candidates would be done by the executive committee of CIRM in private. The names of candidates would then come before the Oversight Committee in a public session for approval or rejection.

Generally board members last week favored the program, declaring it was a good example of public/private partnerships. Klein said that universities have naming programs for lectureships, fellowships and buildings. Oversight Committee member Jeff Sheehy noted the NIH has a naming program for one of its grant efforts.

During his discussion of the plan, Klein implied that he has a potential donor who is very interested in a naming opportunity.

The naming proposal was discussed publicly as early as August during a Governance Subcommittee meeting (see page 66 of the transcript). It came up again late in the day at an Oversight Committee meeting September. It was then that it encountered its only serious opposition(see page 315 of the transcript).

Gayle Wilson, who is no longer a member of the Oversight Committee, said she did not know of other state agencies with similar programs outside of academic institutions. The wife of former Gov. Pete Wilson said, "I don't think it's a good idea. I think we'll be blasted for it."

Tina Nova, another Oversight Committee member and president of Genoptix, a San Diego biotech and lab firm, said,

"I can see a lot of downside because, as we all know, people are constantly trying to figure out what are the motivations, what are the hidden agendas. At the end of the day, people who are trying to support this initiative in a pure sense ought to be doing it for the benefit of seeing the research advance and not for the benefit of seeing their name associated with fellows who are trained. So I think I'm probably more cautious because I do wonder if at the end of the day we could create more challenges and if it really does help us that much."

Nova did not express opposition to the plan on Friday, but she may have left the meeting by the time it came up late in the session. (It is difficult to keep track of the comings and goings of the 29 committee members, particularly late in the meetings.)

Jesse Reynolds of the Center for Genetics and Society voiced the only public opposition to the plan. He said it could "open the door to real or perceived conflicts of interest." For example, he said it would be inappropriate to grant naming rights to Geron, a California stem cell firm. Klein said he was in "heated agreement" on that position.

Our judgment: In a perfect world, CIRM should not do this. But it needs the money and this is relatively benign, although experience tells us that bigtime donors generally expect a quid pro quo. Sometimes they are innocuous (say front row seats at the exciting Oversight Committee meetings). Other times, CIRM officials may have to vigorously resist inappropriate overtures from the $10 million donors. But that is part of the public responsibilities of CIRM executives and board members. Failure to do so will ultimately surface (there are no secrets in government) and embarrass the agency and the officials personally.

Still Coming Up

We have not forgotten our promise for more exciting items from Friday's meeting, particularly the item about naming rights and the strategic plan flap. We still are planning on those and much, much more. So stay in your seats, folks. However, this time we are not going to promise a specific time frame. But certainly sooner than Bob Klein comes up with his $50 million(see item down one from here.)

CIRM-UK Stem Cell Conference Later This Year

The California stem cell agency plans to co-host a joint conference with the United Kingdom's Medical Research Council and CIRM later this year in Great Britain.

Zach Hall, president of CIRM, announced the plans at Friday's Oversight Committee meeting. He said 16 US scientists and 16 UK scientists would convene to discuss stem cell self-renewal and differentiation.

Hall noted that Council is the equivalent to the National Institutes of Health in the United States and that it is unusual for a state organization and a foreign national council to co-host such a conference. The arrangement carries particular weight because the UK is an international leader in stem cell research.

"California has become sort of a surrogate for the U.S. effort on stem cell research," Hall said. The CIRM president credited Stephen Lynn of the British consulate in California with helping to put together the conference.

Lynn is one of the regular attendees at CIRM meetings and keeps close track of its affairs. We also should add that we know of at least several readers of the California Stem Cell Report with UK connections.

Hall said that his agency still must raise funds to uphold its end of the conference.

Klein Confirms $40 Million Commitment

Stem cell chairman Robert Klein says he is not expecting to be ready to have $50 million to hand over to the stem cell agency at its next scheduled meeting in April, but he says he is close.

During a brief interview following Friday's Oversight Committee meeting, we asked him for more details on his efforts to sell bond anticipation notes to fund the activities of the agency. He said he has more than $40 million in commitments but wants $50 million. Then, Klein said, the state treasurer's office will have to take five to six weeks to complete the paperwork, but he declined to go into more detail.

The notes are expected to be sold to philanthropic organizations. If CIRM loses the lawsuits against it, the notes will not be repaid.

The agency will run out of money in June under its present budget plan.

Ortiz Not Satisfied with Egg Expense Rules

California State Sen. Deborah Ortiz has proposed legislation that could overturn plans by the state's stem cell agency to permit egg donors to be reimbursed for lost wages.

Ortiz, chair of the Senate Health Committee, introduced her bill last Thursday, the day before agency was scheduled to consider proposed rules on egg donations. She sent a letter to stem cell Chairman Robert Klein late Thursday that said,

"The amount and difficulty of administering reimbursement for lost wages, and the possibility that such reimbursement may induce women to undergo invasive procedures, merit more attention and consideration before the ICOC acts on this draft provision."

She said that ethical questions exist about whether reimbursement of wages "constitute inducement or coercion for some women."

Ortiz did not send a representative to the Oversight Committee meeting on Friday, nor were her objections discussed in any detail. We may have missed it, but we don't think they were even mentioned. Given the nature of the bureaucratic process, the committee may not have even been aware of them, although there was more mention of cooperating with the legislature than sometimes is heard at Oversight meetings.

Ortiz' bill, SB1260, is a variation of a measure vetoed last year by the governor. SB1260 would ban the sale of human eggs. It would also establish informed consent standards for donors. The bill goes beyond the stem cell agency to regulate all egg donor operations in the state. Ortiz indicated that her bill, which will come up for a hearing sometime this spring, is likely to be altered to include more protections for egg donors. As it now stands, it does not offer as much protection in terms of informed consent procedures for donors as do CIRM regulations.

The sections on egg payments reads:

"No human oocyte or embryo shall be acquired, sold, received, or otherwise transferred for valuable consideration for the purposes of medical research or development of medical therapies. For purposes of this section, 'valuable consideration' does not include reasonable payment for the removal, processing, disposal,preservation, quality control, storage, transplantation, or implantation of oocytes or embryos.

"No payment in excess of the amount of reimbursement of expenses shall be made to any research subject to encourage her to produce human oocytes for the purposes of medical research."

The measure does not specifically mention the "lost wages" issue at this point, but it could easily be added. One could argue that the bill, as it already stands, would ban reimbursement of lost wages.

CIRM's policy requires that only "permissible expenses" can be reimbursed under CIRM-funded research. Those are defined as necessary and reasonable costs directly incurred. They may include, but are not limited to, actual lost wages, travel, housing, child, medical care and health insurance.

Ortiz' letter to Klein said,

"The National Research Council and the Institute of Medicine of the National Academies have recommended that women who undergo egg extraction for research purposes should be reimbursed only for direct expenses incurred as a result of the procedure, as determined by an Institutional Review Board.... This recommendation of an established, credible authority should be carefully considered before opening the door readily to compensation for lost wages in CIRM-funded research, which may set an undue precedent."

Ortiz additionally said that CIRM's policies "should be tightened to more explicitly require eggs procured outside of CIRM-funded research, but used for this research, to meet the guidelines as adopted."

She said that the section "on fairness and diversity in research (should) include the collection of demographic information, including, but not limited to race, ethnicity, language, age, zip code, income bracket, and state that these records need to be made publicly available. This demographic information is important in the continued assessment of who is involved in the research and who may be affected by it."

Bernard Lo, co-chair of the Standards Working Group that developed the ethics policy over months of hearings, on Friday said that CIRM's policies were a starting point and subject to modification as more discussion and evidence are considered. He went out of his way to express public appreciation for input from all parties, including some who have received a more unfriendly reception from others at CIRM in the past.

At the time of the meeting, it was not clear whether he was aware of Ortiz' concerns in her letter from the previous afternoon.

Some might argue that CIRM's status as a separate entity in the California Constitution allows it to chart its own course on "lost wages." That argument might make a fine point for lawyers, but the practical effect of Ortiz's legislation, should it become law as opposed to CIRM's regulations, would seem to nullify the agency's efforts.

Ethics and IP Coverage Mostly Favorable To CIRM

The California stem cell agency can chalk up a plus on coverage of its Friday decisions on ethics and intellectual property.

Generally, California newspapers described the actions as setting standards that go beyond any in the United States, an assertion that not even the critics dispute. Nonetheless, say the critics, the agency could do more.

The meeting also attracted coverage by at least one Bay Area television station (KGO), NPR and the California public radio organization. But coverage by major newspapers elsewhere in the country was nonexistent. We expect to see some coverage over the standards and IP rules in the next couple of months by news organizations outside of California as the news slowly filters east.

The stories also demonstrated some confusion. One example involved a decision by the Oversight Committee concerning financial accessibility of therapies. The committee approved language to make the therapies available to California public agencies at the price paid by Medicaid, a program aimed at the poor. Some reports said Medicare, the health care program for all persons above 65, instead of Medicaid. Another report said the policies approved would become "law." In fact, they will become regulations that have the force of law. The difference is that laws require action by the legislature or voters; regulations can be enacted and changed by the agencies that issue them.

Reporter Jim Wasserman of The Sacramento Bee, who is a relative newcomer to CIRM coverage, described the impact of adoption of the Medicaid language, which replaced language that said the public agency price should be the lowest commercial US price.

"Those discounts are generally 20 to 40 percent, compared with the 40 percent for the federal government's lowest Medicaid price," Wasserman wrote.

He and other reporters noted that some of the Oversight Committee members representing patient groups were concerned about taking actions that might create economic disincentives. To put their point another way, higher potential profits will spur development of therapies that will help those represented by the patient groups.

Other members of the Oversight Committee noted that the low prices apply only in California, implying that prices paid outside of the state will subsidize care for California poor.

Reporter Terri Somers of the San Diego Union-Tribune carried a tidbit also dealing with economic disincentives. It was mentioned in terms of policies requiring the sharing of information from California-funded stem cell research.

"Joydeep Goswami of Carlsbad(CA)-based Invitrogen said such broad sharing of discoveries is eliminating avenues for commercialization. Invitrogen is a major biotechnology tool company that sells to academic research institutions," she wrote.

Sabin Russell of the San Francisco Chronicle reported some criticism of a requirement that egg donors have an adequate period of time to deliberate about their decisions. He wrote that the comment came from "Shannon Smith-Crowley, a lobbyist for the American College of Obstetricians and Gynecologists, who said that the language is evocative of the 'waiting period' rules that are advocated by opponents of abortion. She said such language in the stem cell arena was 'undermining' years of work to establish that women are capable of making important reproductive decisions on their own."

The Los Angeles Times story by Rong-Gong Lin II focused on the delay in CIRM funding caused by the lawsuits against it. The decisions on ethics and sharing revenue was reported in the last two paragraphs.

The Associated Press, which distributes its product nationally and internationally, carried a non-bylined report that appeared to be a rewrite of the Los Angeles Times, to the point of using the Times phrase "in earnest" in the first paragraph. Rewriting news from "member" papers is common at The AP, and a practice they are legally entitled to under their arrangements with the papers.

Both Steve Johnson of the San Jose Mercury News and Wasserman of The Bee wrote stories Thursday and Friday mornings, laying out the issues, as well as reporting for Saturday's editions. (Johnson's story here, Wasserman's here.)

Reporter David Louie of San Francisco TV station KGO prepared a rare TV report on the agency's action. It was a middle-of-the-road piece that did say the policies reflected "best practices." Without seeing the images and hearing the tone, however, it is impossible to make a complete assessment.

Because of the nature of TV news, CIRM has attracted little coverage from those outlets. But TV remains extremely important in terms of public perception since most people get their news from electronic media – not print.

The morning of the meeting -- before action was taken -- opened with a couple of op-ed pieces as well. One was written by Sherry Lansing, Bernard Lo (co-chairs of agency's standards group) and Zach Hall, president of CIRM. The article in the San Francisco Chronicle described the agency's new policies as "the strongest embryonic stem-cell regulations in the country," going "well beyond current national standards for stem-cell research."

On the other hand, Jesse Reynolds of the Center for Genetics and Society wrote in the San Jose Mercury News that "some essential gaps remain to be filled." One example from Reynolds:

"The proposal leaves the approval of research to local committees that will be formed by, and affiliated with, the institutions doing the research. These committees will consist largely of stem-cell researchers themselves and their scientist colleagues from related fields. With this composition, the committees' sympathies and loyalties will lie with their institutions and with the research.

"What's worse, there is no oversight of these committees. Not only would the fox be guarding the hen house, but no one would be watching the fox."

He concluded:

"Too much is at stake with stem-cell research to rely on what may amount to self-regulation. If women's health is to be protected, and misuses of these powerful new technologies prevented, the local committees must be overseen by a transparent and accountable body independent of the research institutions, the CIRM, and the insider's network of scientists."

Research and IP Policies Clear Oversight Committee

The California stem cell agency today approved far-reaching policies to regulate stem cell research and ensure that the state sees a return on its $6 billion investment.

Only minor changes were made to the draft regulations before they cleared CIRM's Oversight Committee. Robert Klein, chairman of the agency, said they went "above and beyond" national standards. While the proposed rules are likely to establish new bench marks across the country, critics were not entirely mollified.

We will carry more on Friday's events during the weekend. Immediately after the session(which ran from 8:30 a.m. to about 5 p.m.), I was pressed into work as a construction grunt by daughter, Karen, a building industry veteran who is running her own home remodel project (addition of a second story and more). I only began reviewing notes from the CIRM meeting at 10 p.m.

Karen, who prefers to be described as a "harsh taskperson" rather than as an "active taskmaster," has directed me to report to work at 6 a.m. Saturday, so full reports out of the Oversight Committee meeting will have to wait until later Saturday and Sunday.

We will tell you about plans to offer up naming rights to CIRM programs to grant donors who hit the $10 million level. We will tell you about a flap about CIRM's long overdue strategic plan. We will give you an update on the fundraising efforts at CIRM, report on a UK-CIRM stem cell conference, examine news coverage of Friday's meeting and more. Plus the latest from Sen. Deborah Ortiz, who has re-introduced her bill to regulate egg donations, and her criticism of CIRM egg policies.

CIRM has issued a press release on Friday's meeting but it is not on its website as the time of this writing and probably will not be posted website until Monday, so the full text is below.