I 

108TH CONGRESS 

1ST SESSION H. R. 399

To amend the Public Health Service Act to promote organ donation. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 28, 2003

Mr. BILIRAKIS (for himself, Mr. BROWN of Ohio, Mr. TAUZIN, Mr. DINGELL, 

Mr. UPTON, Mr. WAXMAN, Mr. BURR, Mr. DEUTSCH, Mr. WYNN, and 

Mr. PALLONE) introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL

To amend the Public Health Service Act to promote organ 

donation.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Organ Donation Im5 provement Act of 2003’’. 

6 SEC. 2. SENSE OF CONGRESS. 

7 (a) PUBLIC AWARENESS OF NEED FOR ORGAN DO8 NATION.—It is the sense of the Congress that the Federal 

9 Government should carry out programs to educate the 
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1 public with respect to organ donation, including the need 

2 to provide for an adequate rate of such donations. 

3 (b) FAMILY DISCUSSIONS OF ORGAN DONATIONS.—

4 The Congress recognizes the importance of families pledg5 ing to each other to share their lives as organ and tissue 

6 donors and acknowledges the importance of discussing 

7 organ and tissue donation as a family. 

8 (c) LIVING DONATIONS OF ORGANS.—The Con9 gress—

10 (1) recognizes the generous contribution made 

11 by each living individual who has donated an organ 

12 to save a life; and 

13 (2) acknowledges the advances in medical tech14 nology that have enabled organ transplantation with 

15 organs donated by living individuals to become a via16 ble treatment option for an increasing number of pa17 tients. 

18 SEC. 3. PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES 

19 INCURRED TOWARD LIVING ORGAN DONA20 TION. 

21 Section 377 of the Public Health Service Act (42 

22 U.S.C. 274f) is amended to read as follows: 

23 ‘‘PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES

24 INCURRED TOWARD LIVING ORGAN DONATION

25 ‘‘SEC. 377. (a) IN GENERAL.—The Secretary may 

26 make awards of grants or contracts to States, transplant 
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1 centers, qualified organ procurement organizations under 

2 section 371, or other public or private entities for the pur3 pose of—

4 ‘‘(1) providing for the payment of travel and 

5 subsistence expenses incurred by individuals toward 

6 making living donations of their organs (in this sec7 tion referred as ‘donating individuals’); and 

8 ‘‘(2) in addition, providing for the payment of 

9 such incidental nonmedical expenses that are so in10 curred as the Secretary determines by regulation to 

11 be appropriate. 

12 ‘‘(b) ELIGIBILITY.—

13 ‘‘(1) IN GENERAL.—Payments under subsection 

14 (a) may be made for the qualifying expenses of a do15 nating individual only if—

16 ‘‘(A) the State in which the donating indi17 vidual resides is a different State than the 

18 State in which the intended recipient of the 

19 organ resides; and 

20 ‘‘(B) the annual income of the intended re21 cipient of the organ does not exceed $35,000 

22 (as adjusted for fiscal year 2004 and subse23 quent fiscal years to offset the effects of infla24 tion occurring after the beginning of fiscal year 

25 2003). 
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1 ‘‘(2) CERTAIN CIRCUMSTANCES.—Subject to 

2 paragraph (1), the Secretary may in carrying out 

3 subsection (a) provide as follows: 

4 ‘‘(A) The Secretary may consider the term 

5 ‘donating individuals’ as including individuals 

6 who in good faith incur qualifying expenses to7 ward the intended donation of an organ but 

8 with respect to whom, for such reasons as the 

9 Secretary determines to be appropriate, no do10 nation of the organ occurs. 

11 ‘‘(B) The Secretary may consider the term 

12 ‘qualifying expenses’ as including the expenses 

13 of having one or more family members of do14 nating individuals accompany the donating indi15 viduals for purposes of subsection (a) (subject 

16 to making payment for only such types of ex17 penses as are paid for donating individuals). 

18 ‘‘(c) LIMITATION ON AMOUNT OF PAYMENT.—

19 ‘‘(1) IN GENERAL.—With respect to the geo20 graphic area to which a donating individual travels 

21 for purposes of subsection (a), if such area is other

22 than the covered vicinity for the intended recipient 

23 of the organ, the amount of qualifying expenses for 

24 which payments under such subsection are made 

25 may not exceed the amount of such expenses for 
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1 which payment would have been made if such area 

2 had been the covered vicinity for the intended recipi3 ent, taking into account the costs of travel and re4 gional differences in the costs of living. 

5 ‘‘(2) COVERED VICINITY.—For purposes of this 

6 section, the term ‘covered vicinity’, with respect to 

7 an intended recipient of an organ from a donating 

8 individual, means the vicinity of the nearest trans9 plant center to the residence of the intended recipi10 ent that regularly performs transplants of that type 

11 of organ. 

12 ‘‘(d) RELATIONSHIP TO PAYMENTS UNDER OTHER

13 PROGRAMS.—An award may be made under subsection (a) 

14 only if the applicant involved agrees that the award will 

15 not be expended to pay the qualifying expenses of a donat16 ing individual to the extent that payment has been made, 

17 or can reasonably be expected to be made, with respect 

18 to such expenses—

19 ‘‘(1) under any State compensation program, 

20 under an insurance policy, or under any Federal or 

21 State health benefits program; or 

22 ‘‘(2) by an entity that provides health services 

23 on a prepaid basis. 

24 ‘‘(e) DEFINITIONS.—For purposes of this section: 
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1 ‘‘(1) The term ‘covered vicinity’ has the mean2 ing given such term in subsection (c)(2). 

3 ‘‘(2) The term ‘donating individuals’ has the 

4 meaning indicated for such term in subsection 

5 (a)(1), subject to subsection (b)(2)(A). 

6 ‘‘(3) The term ‘qualifying expenses’ means the 

7 expenses authorized for purposes of subsection (a), 

8 subject to subsection (b)(2)(B). 

9 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 

10 purpose of carrying out this section, there is authorized 

11 to be appropriated $5,000,000 for each of the fiscal years 

12 2004 through 2008.’’. 

13 SEC. 4. PUBLIC AWARENESS; STUDIES AND DEMONSTRA14 TIONS. 

15 Part H of title III of the Public Health Service Act 

16 (42 U.S.C. 273 et seq.) is amended by inserting after sec17 tion 377 the following section: 

18 ‘‘PUBLIC AWARENESS; STUDIES AND DEMONSTRATIONS

19 ‘‘SEC. 377A. (a) PUBLIC AWARENESS.—The Sec20 retary shall (directly or through grants or contracts) carry 

21 out a program to educate the public with respect to organ 

22 donation, including the need to provide for an adequate 

23 rate of such donations. 

24 ‘‘(b) STUDIES AND DEMONSTRATIONS.—The Sec25 retary may make grants to public and nonprofit private 

26 entities for the purpose of carrying out studies and dem-
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1 onstration projects with respect to providing for an ade2 quate rate of organ donation. 

3 ‘‘(c) GRANTS TO STATES.—The Secretary may make 

4 grants to States for the purpose of assisting States in car5 rying out organ donor awareness, public education and 

6 outreach activities and programs designed to increase the 

7 number of organ donors within the State, including living 

8 donors. To be eligible, each State shall—

9 ‘‘(1) submit an application to the Department 

10 in the form prescribed; 

11 ‘‘(2) establish yearly benchmarks for improve12 ment in organ donation rates in the State; 

13 ‘‘(3) develop, enhance, or expand a State donor 

14 registry, which shall be available to hospitals, organ 

15 procurement organizations, tissue banks, eye banks, 

16 and other States upon a search request; and 

17 ‘‘(4) report to the Secretary on an annual basis 

18 a description and assessment of the State’s use of 

19 these grant funds, accompanied by an assessment of 

20 initiatives for potential replication in other States. 

21 Funds may be used by the State or in partnership with 

22 other public agencies or private sector institutions for edu23 cation and awareness efforts, information dissemination, 

24 activities pertaining to the State donor registry, and other 
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1 innovative donation specific initiatives, including living do2 nation. 

3 ‘‘(d) ANNUAL REPORT TO CONGRESS.—The Sec4 retary shall annually submit to the Congress a report on 

5 the activities carried out under this section, including pro6 visions describing the extent to which the activities have 

7 affected the rate of organ donation. 

8 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—

9 ‘‘(1) IN GENERAL.—For the purpose of car10 rying out this section, there are authorized to be ap11 propriated $15,000,000 for fiscal year 2004, and 

12 such sums as may be necessary for each of the fiscal 

13 years 2005 through 2008. Such authorization of ap14 propriations is in addition to any other authoriza15 tions of appropriations that are available for such 

16 purpose. 

17 ‘‘(2) STUDIES AND DEMONSTRATIONS.—Of the 

18 amounts appropriated under paragraph (1) for a fis19 cal year, the Secretary may not obligate more than 

20 $2,000,000 for carrying out subsection (b).’’. 

21 SEC. 5. EFFECTIVE DATE. 

22 The amendments made by this Act take effect on the 

23 date of the enactment of this Act.

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