All Over Albany

A booming global industry, human blood, and an Albany strip mall

The blood coursing through all our veins -- or, specifically, a portion of that blood -- has become a key component in a booming industry.

Products made from blood plasma are worth more than $100 billion annually worldwide. Much of that plasma comes from the United States. It's used both here and abroad for all sorts of life-saving treatments.

Now that global industry is looking to expand to... a strip mall in Albany.

And that's prompted some concerns.

What is blood plasma? How is it collected?

A quick refresher from biology class: Plasma is the liquid portion of blood, and it makes up a little more than half of the volume in a given unit of whole blood. It's almost completely made up of water. But the little bit that's not includes proteins that can be turned into therapies for people suffering from trauma, burns, conditions such as hemophilia, and various diseases.

Plasma is collected much the same way that whole blood is -- via a needle in the arm. A machine draws in the whole blood and then separates the red blood cells from the plasma. Those cells are then returned to the body and the plasma stays collected. (The technical term for this process is plasmapheresis.)

One unit of plasma. The color of plasma is often called "straw." / photo: Wikipedia user DiverDave (CC BY-SA 3.0)

Companies can pay for it?

Unlike blood donations, companies pay donors for collecting plasma. Representatives of a company called CSL Plasma told the Albany planning board during a June 11 workshop session that donors typically are given about $40 for each collection session.

This STAT article looks at some of the historical and technical reasons for why that is. But the short explanation is the products made from plasma can be processed to remove diseases in ways that whole blood can't be, which mitigates some of the concerns about people lying or otherwise not being forthcoming when being screened as donors. (Potential donors still go through a screening process, and the CSL reps said during the planning board workshop that only about a third of applicants make it through the screen.) The feds allow donors to give plasma twice a week as along as donors weigh at least 110 pounds.

Still, that prompts some ethical questions because most people aren't going to be willing to spend an hour or so with a needle stuck in their arm for $40*. So donors tend to really need the money, such as people struggling to pay for living expenses and college students. The CSL reps said at that workshop that college students are a key donor market for them. (* Which is often paid on a gift card-style debit card, a practice that its own complications.)

And those economically vulnerable people are contributing to a huge global trade.

This is a booming, global business

The global market for blood plasma exports was $126 billion in 2016, as The Economist recently noted in a profile of the industry and debates about paying for plasma donations. In part because it allows paid donations, the United States is the world's major supplier. (The head of a network of blood banks once referred to the US as "the OPEC of plasma.")

The industry is dominated by a handful of large international corporations. From a recent consultancy report abstract: the "competitive landscape of the market is of oligopoly form". CSL is one of these companies.

And worldwide demand for the therapeutic products derived from plasma continues to grow. So, too, has the number of plasma collection centers in the United States.

What this all has to do with Albany

The areas of the city where plasma collection centers would be allowed. (click the image for a larger view)

There are currently just a few active plasma collection centers in New York State, according to an online FDA license database: A CSL center in Greece, just outside of Rochester, and one operated by KED Plasma (another industry giant) in Williamsville, near Buffalo. But CSL has big plans for expansion in New York. Its website notes nine "coming soon" sites across the state, including Schenectady and Albany.

And that leads to the specific situation in Albany. CSL Plasma has been working for roughly the past year to open a plasma collection center in a vacant storefront space at the Hannaford Plaza on Central Ave.

Plasma collection center doesn't neatly fit into the city's existing zoning, so the project went before the city's Board of Zoning Appeals last fall trying to get some sort of ruling that would open the way for it. (The BZA declined.) And now the city is looking at creating use-specific standards in its zoning code to allow plasma collection centers.

Specifically, the city's planning department has laid out a set of rules that would make a plasma center a conditional use in a handful of zones (see the map above). The standards, from a planning department memo:

1. Facilities must be at least 250 feet from the nearest boundary line of a lot with a Household Living use; a Group Living use, a Religious Institution; or a School.

2. All equipment, samples, and products must be stored inside the building;

3. Facilities must provide and follow a management plan for handling litter, outdoor queuing, security and loitering;

4. Facilities shall include waiting and departure lounge sufficient in size, but a minimum of five hundred (500) square feet, to accommodate all scheduled donors within one hour prior to their appointment and one hour after, as well as any anticipated drop-in patrons. Such waiting areas shall include restroom facilities and be open at least on hour prior to the opening of the center for business for the use of waiting patrons.

Chris Spencer, the city's planning and development commissioner, said the rules were initially shaped in part by the city's experiences with methadone clinics, which popped up as part of a broader zoning category and have since prompted complaints about loitering and double parking. (The city is also moving to adopt specific zoning standards for methadone clinics.)

"We want to make sure that [plasma centers] have sufficient room in the waiting room so there weren't people milling outside and make sure that people would be taken care of after they've taken gotten their treatment or made their donation," Spencer said after last Thursday's planning board meeting. "We want to make sure all of those things were taken [into account], that the building itself was sufficient that it wasn't some place on a street where people are going to be double parked as they were dropping off and loading."

Skepticism and pushback

But the new rules have gotten pushback, primarily from Common Council member Michael O'Brien, for not being restrictive enough.

O'Brien has been critical of setting the buffer between plasma centers and residential areas / churches / schools at 250 feet. He points to the initial rules first floated by the planning department last year that set the buffer at 1,000 feet.

"Does it have to be a thousand feet? I don't know if that's the magic number," O'Brien said at the planning board workshop earlier this month. "But why is it suddenly spinning it at 250 now when they already decided the thousand for methadone, 500 for marijuana dispensary. Why has it now magically [become] 250 with this one. Why isn't it more the 500 or 750 range?"

O'Brien seems skeptical of the industry generally. His response when we asked about the possible perception that pushback on these sorts of facilities was about trying to keep poor people out of an area: "No, this is victimizing poor people. That's what I think it is. And it isn't just for that location. This regulation applies to the whole city."

O'Brien was joined by five residents expressing opposition or skepticism to the new rules during public comments as part of public hearing at last week's planning board meeting. They said they were concerned about effects on residential areas, and pointed to crime and other disruptions at plasma centers in news reports from other parts of the country.

Common Council member Judy Doesschate also spoke, noting she thought it was unfair that CSL was allowed to make an informational presentation about its business at the planning board workshop but residents weren't allowed to speak to the specific site because the hearing was about the standards generally.

And during his comment O'Brien questioned the change of the buffer zone, questioned the work the planning department had done to determine the size of the buffer, and alleged the whole process was violating rules of procedure.

That's when things got a bit testy -- board chair Al DeSalvo said he took exception to the last allegation. And then O'Brien got upset when an attorney from Whiteman Osterman & Hanna -- who was there to represent CSL -- got the chance to speak last during the public comment. (O'Brien had requested that spot, a courtesy often afforded to council members. The planning staff member coordinating the speakers list said the order had just gotten mixed up.) O'Brien then left the meeting during the attorney's comments.

Tabled

The actual power to change the city's zoning rests with the Common Council. And the item up before the planning board during the public hearing was a recommendation to the council. (It's essentially a formal opinion.)

After all the back and forth, planning board member Christopher Ellis moved to table the question. And board member Roman Kuchera seconded it, noting he'd like the board to get advice from the city's attorneys. And chair Al DeSalvo recommended the board seek input from the state Department of Health.

The board voted unanimously to table the question.

After the meeting, Chris Spencer said the 1,000-foot buffer was initially proposed because of the concurrent effort to regulate methadone dispensaries.

"Then as we learned more and more about these donation centers, we became more and more comfortable with the impacts and felt that the use-specific standards that we had were sufficient to deal with any kind of impacts that might be," Spencer said. "So the 1000 feet in retrospect probably would've been an overreach. I don't know that there are too many other communities, the ones that we looked at, that they could even find a thousand. There may be one or two. But generally most of them were not done under a separate use. Most of them had no limitations in terms of the radius around them -- when they did they were in the range of I think 200 to 500."

And why not just set the buffer at 1,000 feet, just in case?

"Well, I think what you do then is you're putting [plasma collection centers] potentially in places where they're not on a bus line, where they're not in an area that's walkable, where the people that benefit from some of the income that's derived from this, from their time in the donation, wouldn't have that ability," he said. "We don't like to zone things just because there's no harm in making it more difficult for something. Our zoning is very specific in terms of we want to find out what the impacts are, if there are any impacts, and we prefer to use specific standards around those. We don't try to create things that are just in case."

Spencer said the board was following the procedures in the zoning code for holding a public hearing about the recommendation, and the final decision will be in the hands of the Common Council. He also said the department will continue to research the topic and it will look at putting together some sort of report about its conclusions.