(B) The Secretary shall ensure that, for
fiscal 1994, the number of employees of the De-
partment of Health and Human Services who
are engaged in carrying out the program trans-
ferred by paragraph (1) is not less than the
number of employees who were so engaged on
June 28, 1993.
(b) PATIENT ADVOCACY; RECRUITMENT
OF DO-
NORS.—Section 379 of the Public Health Service Act (42
U.S.C. 274k) is amended—
(1) in subsection (b)—
(A) in paragraph (2), by striking ‘‘estab-
lish’’ and all that follows and inserting the fol-
lowing: ‘‘establish a program for patient advo-
cacy in accordance with subsection (j);’’; and
(B) in paragraph (5), by striking ‘‘recruit’’
and all that follows and inserting the following:
‘‘establish a program for the recruitment of
bone marrow donors in accordance with sub-
section (k);’’;
(2) by striking subsection (j); and
(3) by inserting after subsection (i) the follow-
ing subsections:
‘‘(j) PATIENT ADVOCACY.—For purposes of sub-
section (b)(2), a program for patient advocacy is estab-
lished in accordance with this subsection if—
‘‘(1) the program is headed by a director;
‘‘(2) with respect to the procurement of bone
marrow, the program provides that the Director is
to serve as an advocate on behalf of—
‘‘(A) individuals who are registered with
the Registry to become a recipient of a trans-
plant from a biologically unrelated donor;
‘‘(B) the families of such individuals; and
‘‘(C) the physicians involved;
‘‘(3) the program provides case management
services for such individuals, families, and physi-
cians; and
‘‘(4) the program meets such other criteria as
the Secretary may establish.
‘‘(k) RECRUITMENT OF DONORS.—For purposes of
subsection (b)(5), a program for the recruitment of bone
marrow donors is established in accordance with this sub-
section if—
‘‘(1) in recruiting an individual to enroll in the
Registry, and in each subsequent stage of the proc-
ess of recruitment, the program provides to the indi-
vidual information regarding the possibility that, if
it is determined that it is medically inappropriate for
the individual to be a donor for the patient involved,
a sibling of the individual may nevertheless be a
medically appropriate donor for the patient;
‘‘(2) in the case of an individual who is enrolled
with the Registry, the program provides for annual
(or more frequent) informational mailings to each
such individual, which mailings concern the status of
the activities of the Registry;
‘‘(3) the program provides for the training of
counselors to meet individually with individuals who
are so enrolled and who, pursuant to the Registry,
have been requested to undergo confirmatory testing
pursuant to a search for bone marrow for a particu-
lar patient;
‘‘(4) in the case of an individual described in
paragraph (3), the program provides to the individ-
ual a general description of the medical condition of
the patient involved and an assessment of the possi-
bility that the individual is a medically appropriate
donor for the patient; and
‘‘(5) the program meets such other criteria as
the Secretary may establish.’’.
SEC. 5. STUDY BY GENERAL ACCOUNTING OFFICE.
(a) IN GENERAL.—Section 379A(a) of the Public
Health Service Act (42 U.S.C. 274l(a)) is amended by
striking ‘‘conduct’’ in the matter preceding paragraph (1)
and all that follows and inserting the following: ‘‘conduct
a study for the purpose of—
‘‘(1) assessing the extent to which the program
carried out under section 379 maintains the con-
fidentiality of the identity of individuals who are en-
rolled with the Registry;
‘‘(2) assessing the extent to which such individ-
uals cooperate with the Registry when the Registry
requests the individuals to undergo supplemental
testing regarding the donation of bone marrow;
‘‘(3) assessing, in the case of such individuals
who have been determined to be medically appro-
priate donors of bone marrow for the patients in-
volved, the extent to which such individuals are will-
ing to make a donation of bone marrow;
‘‘(4) assessing the extent to which activities car-
ried out pursuant to section 379(k) provide informa-
tion to the individuals involved that is sufficient for
the individuals to make informed decisions regarding
the donation of bone marrow;
‘‘(5) assessing the extent to which the case
management 
services 
provided 
under 
section
379(j)(3) are effective in assisting patients in receiv-
ing the transplants involved;
‘‘(6) developing recommendations on improving
the program of the Registry, including proposals to
increase the number of transplants with successful
outcomes while maintaining the confidentiality of the
identity of the individuals authorizing the donations
of bone marrow;
‘‘(7) assessing the extent to which efforts to re-
cruit minority individuals to enroll in the Registry
have been successful;
‘‘(8) assessing, in the case of minority individ-
uals who have been medically referred to receive a
transplant of bone marrow, the measures that
should be implemented to ensure that the Registry
provides for such individuals a probability of locating
a biologically unrelated, medically appropriate donor
that is reasonably equivalent to the probability that
exists with respect to Caucasian individuals who
have been so referred; and
‘‘(9) assessing the extent to which the fees im-
posed by transplant centers with respect to the
search for a donor of bone marrow, when considered
in light of the fees imposed by the Registry, con-