I 
108TH CONGRESS 
2D SESSION 
H. R. 3926
To amend the Public Health Service Act to promote organ donation, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 10, 2004
Mr. BILIRAKIS (for himself, Mr. BROWN of Ohio, Mr. BARTON of Texas, Mr. 
DINGELL, Mr. UPTON, Mr. WAXMAN, Mr. BURR, and Mr. PALLONE) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To amend the Public Health Service Act to promote organ 
donation, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Organ Donation and 
Recovery Improvement Act’’. 
SEC. 2. SENSE OF CONGRESS. 
(a) PUBLIC AWARENESS OF NEED FOR ORGAN DO-
NATION.—It is the sense of Congress that the Federal 
Government should carry out programs to educate the
public with respect to organ donation, including the need 
to provide for an adequate rate of such donations. 
(b) FAMILY DISCUSSIONS OF ORGAN DONATIONS.—
Congress recognizes the importance of families pledging 
to each other to share their lives as organ and tissue do-
nors and acknowledges the importance of discussing organ 
and tissue donation as a family. 
(c) LIVING DONATIONS OF ORGANS.—Congress—
(1) recognizes the generous contribution made 
by each living individual who has donated an organ 
to save a life; and 
(2) acknowledges the advances in medical tech-
nology that have enabled organ transplantation with 
organs donated by living individuals to become a via-
ble treatment option for an increasing number of pa-
tients. 
SEC. 3. REIMBURSEMENT OF TRAVEL AND SUBSISTENCE 
EXPENSES 
INCURRED 
TOWARD 
LIVING 
ORGAN DONATION. 
Section 377 of the Public Health Service Act (42 
U.S.C. 274f) is amended to read as follows:
‘‘SEC. 377. REIMBURSEMENT OF TRAVEL AND SUBSISTENCE 
EXPENSES 
INCURRED 
TOWARD 
LIVING 
ORGAN DONATION. 
‘‘(a) IN GENERAL.—The Secretary may award grants 
to States, transplant centers, qualified organ procurement 
organizations under section 371, or other public or private 
entities for the purpose of—
‘‘(1) providing for the reimbursement of travel 
and subsistence expenses incurred by individuals to-
ward making living donations of their organs (in this 
section referred to as ‘donating individuals’); and 
‘‘(2) providing for the reimbursement of such 
incidental nonmedical expenses that are so incurred 
as the Secretary determines by regulation to be ap-
propriate. 
‘‘(b) PREFERENCE.—The Secretary shall, in carrying 
out subsection (a), give preference to those individuals 
that the Secretary determines are more likely to be other-
wise unable to meet such expenses. 
‘‘(c) CERTAIN
CIRCUMSTANCES.—The Secretary 
may, in carrying out subsection (a), consider—
‘‘(1) the term ‘donating individuals’ as includ-
ing individuals who in good faith incur qualifying ex-
penses toward the intended donation of an organ but 
with respect to whom, for such reasons as the Sec-
retary determines to be appropriate, no donation of 
the organ occurs; and 
‘‘(2) the term ‘qualifying expenses’ as including 
the expenses of having relatives or other individuals, 
not to exceed 2, accompany or assist the donating 
individual for purposes of subsection (a) (subject to 
making payment for only those types of expenses 
that are paid for a donating individual). 
‘‘(d) RELATIONSHIP TO PAYMENTS UNDER OTHER 
PROGRAMS.—An award may be made under subsection (a) 
only if the applicant involved agrees that the award will 
not be expended to pay the qualifying expenses of a donat-
ing individual to the extent that payment has been made, 
or can reasonably be expected to be made, with respect 
to such expenses—
‘‘(1) under any State compensation program, 
under an insurance policy, or under any Federal or 
State health benefits program; 
‘‘(2) by an entity that provides health services 
on a prepaid basis; or 
‘‘(3) by the recipient of the organ. 
‘‘(e) DEFINITIONS.—For purposes of this section: 
‘‘(1) The term ‘donating individuals’ has the 
meaning indicated for such term in subsection 
(a)(1), subject to subsection (c)(1).
‘‘(2) The term ‘qualifying expenses’ means the 
expenses authorized for purposes of subsection (a), 
subject to subsection (c)(2). 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated $5,000,000 for each of the fiscal years 
2005 through 2009.’’. 
SEC. 4. PUBLIC AWARENESS; STUDIES AND DEMONSTRA-
TIONS. 
Part H of title III of the Public Health Service Act 
(42 U.S.C. 273 et seq.) is amended by inserting after sec-
tion 377 the following: 
‘‘SEC. 377A. PUBLIC AWARENESS; STUDIES AND DEM-
ONSTRATIONS. 
‘‘(a) ORGAN DONATION PUBLIC AWARENESS PRO-
GRAM.—The Secretary shall, directly or through grants or 
contracts, establish a public education program in co-
operation with existing national public awareness cam-
paigns to increase awareness about organ donation and 
the need to provide for an adequate rate of such donations. 
‘‘(b) STUDIES
AND DEMONSTRATIONS.—The Sec-
retary may make peer-reviewed grants to, or enter into 
peer-reviewed contracts with, public and nonprofit private 
entities for the purpose of carrying out studies and dem-
onstration projects to increase organ donation and recov-
ery rates, including living donation. 
‘‘(c) GRANTS TO STATES.—
‘‘(1) IN GENERAL.—The Secretary may make 
grants to States for the purpose of assisting States 
in carrying out organ donor awareness, public edu-
cation, and outreach activities and programs de-
signed to increase the number of organ donors with-
in the State, including living donors. 
‘‘(2) ELIGIBILITY.—To be eligible to receive a 
grant under this subsection, a State shall—
‘‘(A) submit an application to the Depart-
ment in the form prescribed; 
‘‘(B) establish yearly benchmarks for im-
provement in organ donation rates in the State; 
and 
‘‘(C) report to the Secretary on an annual 
basis a description and assessment of the 
State’s use of funds received under this sub-
section, accompanied by an assessment of ini-
tiatives for potential replication in other States. 
‘‘(3) USE OF FUNDS.—Funds received under 
this subsection may be used by the State, or in part-
nership with other public agencies or private sector 
institutions, for education and awareness efforts, in-
formation dissemination, activities pertaining to the 
State donor registry, and other innovative donation 
specific initiatives, including living donation. 
‘‘(d) EDUCATIONAL ACTIVITIES.—The Secretary, in 
coordination with the Organ Procurement and Transplan-
tation Network and other appropriate organizations, shall 
support the development and dissemination of educational 
materials to inform health care professionals and other ap-
propriate professionals in issues surrounding organ, tis-
sue, and eye donation including evidence-based proven 
methods to approach patients and their families, cultural 
sensitivities, and other relevant issues. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $15,000,000 for fiscal year 2005, and 
such sums as may be necessary for each of the fiscal years 
2006 through 2009. Such authorization of appropriations 
is in addition to any other authorizations of appropriations 
that are available for such purpose. 
‘‘SEC. 377B. GRANTS REGARDING HOSPITAL ORGAN DONA-
TION COORDINATORS. 
‘‘(a) AUTHORITY.—
‘‘(1) IN GENERAL.—The Secretary may award 
grants to qualified organ procurement organizations 
and hospitals under section 371 to establish pro-
grams coordinating organ donation activities of eligi-
ble hospitals and qualified organ procurement orga-
nizations under section 371. Such activities shall be 
coordinated to increase the rate of organ donations 
for such hospitals. 
‘‘(2) ELIGIBLE
HOSPITAL.—For purposes of 
this section, the term ‘eligible hospital’ means a hos-
pital that performs significant trauma care, or a 
hospital or consortium of hospitals that serves a 
population base of not fewer than 200,000 individ-
uals. 
‘‘(b) ADMINISTRATION
OF
COORDINATION
PRO-
GRAM.—A condition for the receipt of a grant under sub-
section (a) is that the applicant involved agree that the 
program under such subsection will be carried out joint-
ly—
‘‘(1) by representatives from the eligible hos-
pital and the qualified organ procurement organiza-
tion with respect to which the grant is made; and 
‘‘(2) by such other entities as the representa-
tives referred to in paragraph (1) may designate. 
‘‘(c) REQUIREMENTS.—Each entity receiving a grant 
under subsection (a) shall—
‘‘(1) establish joint organ procurement organi-
zation and hospital designated leadership responsi-
bility and accountability for the project; 
‘‘(2) develop mutually agreed upon overall 
project performance goals and outcome measures, 
including interim outcome targets; and 
‘‘(3) collaboratively design and implement an 
appropriate data collection process to provide ongo-
ing feedback to hospital and organ procurement or-
ganization leadership on project progress and re-
sults. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to interfere with regulations in 
force on the date of enactment of the Organ Donation and 
Recovery Improvement Act. 
‘‘(e) EVALUATIONS.—Within 3 years after the award 
of grants under this section, the Secretary shall ensure 
an evaluation of programs carried out pursuant to sub-
section (a) in order to determine the extent to which the 
programs have increased the rate of organ donation for 
the eligible hospitals involved. 
‘‘(f) MATCHING REQUIREMENT.—The Secretary may 
not award a grant to a qualifying organ donation entity 
under this section unless such entity agrees that, with re-
spect to costs to be incurred by the entity in carrying out
activities for which the grant was awarded, the entity shall 
contribute (directly or through donations from public or 
private entities) non-Federal contributions in cash or in 
kind, in an amount equal to not less than 30 percent of 
the amount of the grant awarded to such entity. 
‘‘(g) FUNDING.—For the purpose of carrying out this 
section, there are authorized to be appropriated 
$3,000,000 for fiscal year 2005, and such sums as may 
be necessary for each of fiscal years 2006 through 2009.’’. 
SEC. 5. STUDIES RELATING TO ORGAN DONATION AND THE 
RECOVERY, PRESERVATION, AND TRANSPOR-
TATION OF ORGANS. 
Part H of title III of the Public Health Service Act 
(42 U.S.C. 273 et seq.) is amended by inserting after sec-
tion 377B, as added by section 4, the following: 
‘‘SEC. 377C. STUDIES RELATING TO ORGAN DONATION AND 
THE RECOVERY, PRESERVATION, AND TRANS-
PORTATION OF ORGANS. 
‘‘(a) DEVELOPMENT
OF
SUPPORTIVE
INFORMA-
TION.—The Secretary, acting through the Director of the 
Agency for Healthcare Research and Quality, shall develop 
scientific evidence in support of efforts to increase organ 
donation and improve the recovery, preservation, and 
transportation of organs.
‘‘(b) ACTIVITIES.—In carrying out subsection (a), the 
Secretary shall—
‘‘(1) conduct or support evaluation research to 
determine whether interventions, technologies, or 
other activities improve the effectiveness, efficiency, 
or quality of existing organ donation practice; 
‘‘(2) undertake or support periodic reviews of 
the scientific literature to assist efforts of profes-
sional societies to ensure that the clinical practice 
guidelines that they develop reflect the latest sci-
entific findings; 
‘‘(3) ensure that scientific evidence of the re-
search and other activities undertaken under this 
section is readily accessible by the organ procure-
ment workforce; and 
‘‘(4) work in coordination with the appropriate 
professional societies as well as the Organ Procure-
ment and Transplantation Network and other organ 
procurement and transplantation organizations to 
develop evidence and promote the adoption of such 
proven practices. 
‘‘(c) RESEARCH
AND DISSEMINATION.—The Sec-
retary, acting through the Director of the Agency for 
Healthcare Research and Quality, as appropriate, shall
provide support for research and dissemination of find-
ings, to—
‘‘(1) develop a uniform clinical vocabulary for 
organ recovery; 
‘‘(2) apply information technology and tele-
communications to support the clinical operations of 
organ procurement organizations; 
‘‘(3) enhance the skill levels of the organ pro-
curement workforce in undertaking quality improve-
ment activities; and 
‘‘(4) assess specific organ recovery, preserva-
tion, and transportation technologies. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $2,000,000 for fiscal year 2005, and 
such sums as may be necessary for each of fiscal years 
2006 through 2009.’’. 
SEC. 6. REPORT RELATING TO ORGAN DONATION AND THE 
RECOVERY, PRESERVATION, AND TRANSPOR-
TATION OF ORGANS. 
Part H of title III of the Public Health Service Act 
(42 U.S.C. 273 et seq.) is amended by inserting after sec-
tion 377C, as added by section 5, the following:
‘‘SEC. 377D. REPORT RELATING TO ORGAN DONATION AND 
THE RECOVERY, PRESERVATION, AND TRANS-
PORTATION OF ORGANS. 
‘‘(a) IN GENERAL.—Not later than December 31, 
2005, and every 2 years thereafter, the Secretary shall re-
port to the appropriate committees of Congress on the ac-
tivities of the Department carried out pursuant to this 
part, including an evaluation describing the extent to 
which the activities have affected the rate of organ dona-
tion and recovery. 
‘‘(b) REQUIREMENTS.—To the extent practicable, 
each report submitted under subsection (a) shall—
‘‘(1) evaluate the effectiveness of activities, 
identify effective activities, and disseminate such 
findings with respect to organ donation and recov-
ery; 
‘‘(2) assess organ donation and recovery activi-
ties that are recently completed, ongoing, or 
planned; and 
‘‘(3) evaluate progress on the implementation of 
the plan required under subsection (c)(5). 
‘‘(c) INITIAL REPORT REQUIREMENTS.—The initial 
report under subsection (a) shall include the following: 
‘‘(1) An evaluation of the organ donation prac-
tices of organ procurement organizations, States, 
other countries, and other appropriate organizations
consent, and recommendations regarding improving 
the effectiveness of State donor registries in increas-
ing overall organ donation rates. 
‘‘(5) A plan to improve federally supported or 
conducted organ donation and recovery activities, in-
cluding, when appropriate, the establishment of 
baselines and benchmarks to measure overall out-
comes of these programs. Such plan shall provide for 
the ongoing coordination of federally supported or 
conducted organ donation and research activities.’’. 
SEC. 7. NATIONAL LIVING DONOR MECHANISMS. 
Part H of title III of the Public Health Service Act 
(42 U.S.C. 273 et seq.) is amended by inserting after sec-
tion 371 the following: 
‘‘SEC. 371A. NATIONAL LIVING DONOR MECHANISMS. 
‘‘The Secretary may establish and maintain mecha-
nisms to evaluate the long-term effects associated with liv-
ing organ donations by individuals who have served as liv-
ing donors.’’. 
SEC. 8. STUDY. 
Not later than December 31, 2004, the Secretary of 
Health and Human Services, in consultation with appro-
priate entities, including advocacy groups representing 
those populations that are likely to be disproportionately 
affected by proposals to increase cadaveric donation, shall
submit to the appropriate committees of Congress a report 
that evaluates the ethical implications of such proposals. 
SEC. 9. QUALIFIED ORGAN PROCUREMENT ORGANIZA-
TIONS. 
Section 371(a) of the Public Health Service Act (42 
U.S.C. 273(a)) is amended by striking paragraph (3).
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