IIB 

108TH CONGRESS 

1ST SESSION H. R. 399

IN THE SENATE OF THE UNITED STATES 

MARCH 13, 2003

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT

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,
2

HR 399 RFS 

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Organ Donation Im3 provement Act of 2003’’. 

4 SEC. 2. SENSE OF CONGRESS. 

5 (a) PUBLIC AWARENESS OF NEED FOR ORGAN DO6 NATION.—It is the sense of the Congress that the Federal 

7 Government should carry out programs to educate the 

8 public with respect to organ donation, including the need 

9 to provide for an adequate rate of such donations. 

10 (b) FAMILY DISCUSSIONS OF ORGAN DONATIONS.—

11 The Congress recognizes the importance of families pledg12 ing to each other to share their lives as organ and tissue 

13 donors and acknowledges the importance of discussing 

14 organ and tissue donation as a family. 

15 (c) LIVING DONATIONS OF ORGANS.—The Con16 gress—

17 (1) recognizes the generous contribution made 

18 by each living individual who has donated an organ 

19 to save a life; and 

20 (2) acknowledges the advances in medical tech21 nology that have enabled organ transplantation with 

22 organs donated by living individuals to become a via23 ble treatment option for an increasing number of pa24 tients. 
3

HR 399 RFS 

1 SEC. 3. PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES 

2 INCURRED TOWARD LIVING ORGAN DONA3 TION. 

4 Section 377 of the Public Health Service Act (42 

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

6 ‘‘PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES

7 INCURRED TOWARD LIVING ORGAN DONATION

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

9 make awards of grants or contracts to States, transplant 

10 centers, qualified organ procurement organizations under 

11 section 371, or other public or private entities for the pur12 pose of—

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

14 subsistence expenses incurred by individuals toward 

15 making living donations of their organs (in this sec16 tion referred as ‘donating individuals’); and 

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

18 such incidental nonmedical expenses that are so in19 curred as the Secretary determines by regulation to 

20 be appropriate. 

21 ‘‘(b) ELIGIBILITY.—

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

23 (a) may be made for the qualifying expenses of a do24 nating individual only if—

25 ‘‘(A) the State in which the donating indi26 vidual resides is a different State than the 
4

HR 399 RFS 

1 State in which the intended recipient of the 

2 organ resides; and 

3 ‘‘(B) the annual income of the intended re4 cipient of the organ does not exceed $35,000 

5 (as adjusted for fiscal year 2004 and subse6 quent fiscal years to offset the effects of infla7 tion occurring after the beginning of fiscal year 

8 2003). 

9 ‘‘(2) CERTAIN CIRCUMSTANCES.—Subject to 

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

11 subsection (a) provide as follows: 

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

13 ‘donating individuals’ as including individuals 

14 who in good faith incur qualifying expenses to15 ward the intended donation of an organ but 

16 with respect to whom, for such reasons as the 

17 Secretary determines to be appropriate, no do18 nation of the organ occurs. 

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

20 ‘qualifying expenses’ as including the expenses 

21 of having one or more family members of do22 nating individuals accompany the donating indi23 viduals for purposes of subsection (a) (subject 

24 to making payment for only such types of ex25 penses as are paid for donating individuals). 
5

HR 399 RFS 

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

2 ‘‘(1) IN GENERAL.—With respect to the geo3 graphic area to which a donating individual travels 

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

5 than the covered vicinity for the intended recipient 

6 of the organ, the amount of qualifying expenses for 

7 which payments under such subsection are made 

8 may not exceed the amount of such expenses for 

9 which payment would have been made if such area 

10 had been the covered vicinity for the intended recipi11 ent, taking into account the costs of travel and re12 gional differences in the costs of living. 

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

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

15 an intended recipient of an organ from a donating 

16 individual, means the vicinity of the nearest trans17 plant center to the residence of the intended recipi18 ent that regularly performs transplants of that type 

19 of organ. 

20 ‘‘(d) RELATIONSHIP TO PAYMENTS UNDER OTHER

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

22 only if the applicant involved agrees that the award will 

23 not be expended to pay the qualifying expenses of a donat24 ing individual to the extent that payment has been made, 
6

HR 399 RFS 

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

2 to such expenses—

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

4 under an insurance policy, or under any Federal or 

5 State health benefits program; or 

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

7 on a prepaid basis. 

8 ‘‘(e) DEFINITIONS.—For purposes of this section: 

9 ‘‘(1) The term ‘covered vicinity’ has the mean10 ing given such term in subsection (c)(2). 

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

12 meaning indicated for such term in subsection 

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

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

15 expenses authorized for purposes of subsection (a), 

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

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

18 purpose of carrying out this section, there is authorized 

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

20 2004 through 2008.’’. 

21 SEC. 4. PUBLIC AWARENESS; STUDIES AND DEMONSTRA22 TIONS. 

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

24 (42 U.S.C. 273 et seq.) is amended by inserting after sec25 tion 377 the following section: 
7

HR 399 RFS 

1 ‘‘PUBLIC AWARENESS; STUDIES AND DEMONSTRATIONS

2 ‘‘SEC. 377A. (a) PUBLIC AWARENESS.—The Sec3 retary shall (directly or through grants or contracts) carry 

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

5 donation, including the need to provide for an adequate 

6 rate of such donations. 

7 ‘‘(b) STUDIES AND DEMONSTRATIONS.—The Sec8 retary may make grants to public and nonprofit private 

9 entities for the purpose of carrying out studies and dem10 onstration projects with respect to providing for an ade11 quate rate of organ donation. 

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

13 grants to States for the purpose of assisting States in car14 rying out organ donor awareness, public education and 

15 outreach activities and programs designed to increase the 

16 number of organ donors within the State, including living 

17 donors. To be eligible, each State shall—

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

19 in the form prescribed; 

20 ‘‘(2) establish yearly benchmarks for improve21 ment in organ donation rates in the State; 

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

23 registry, which shall be available to hospitals, organ 

24 procurement organizations, tissue banks, eye banks, 

25 and other States upon a search request; and 
8

HR 399 RFS 

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

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

3 these grant funds, accompanied by an assessment of 

4 initiatives for potential replication in other States. 

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

6 other public agencies or private sector institutions for edu7 cation and awareness efforts, information dissemination, 

8 activities pertaining to the State donor registry, and other 

9 innovative donation specific initiatives, including living do10 nation. 

11 ‘‘(d) ANNUAL REPORT TO CONGRESS.—The Sec12 retary shall annually submit to the Congress a report on 

13 the activities carried out under this section, including pro14 visions describing the extent to which the activities have 

15 affected the rate of organ donation. 

16 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—

17 ‘‘(1) IN GENERAL.—For the purpose of car18 rying out this section, there are authorized to be ap19 propriated $15,000,000 for fiscal year 2004, and 

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

21 years 2005 through 2008. Such authorization of ap22 propriations is in addition to any other authoriza23 tions of appropriations that are available for such 

24 purpose. 
9

HR 399 RFS 

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

2 amounts appropriated under paragraph (1) for a fis3 cal year, the Secretary may not obligate more than 

4 $2,000,000 for carrying out subsection (b).’’. 

5 SEC. 5. EFFECTIVE DATE. 

6 The amendments made by this Act take effect on the 

7 date of the enactment of this Act.

Passed the House of Representatives March 12, 

2003. 

Attest: JEFF TRANDAHL, 

Clerk.