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.
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 Im-
provement Act of 2003’’. 
SEC. 2. SENSE OF CONGRESS. 
(a) PUBLIC AWARENESS OF NEED FOR ORGAN DO-
NATION.—It is the sense of the 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.—
The Congress recognizes the importance of families pledg-
ing to each other to share their lives as organ and tissue 
donors and acknowledges the importance of discussing 
organ and tissue donation as a family. 
(c) LIVING DONATIONS
OF ORGANS.—The Con-
gress—
(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. PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES 
INCURRED TOWARD LIVING ORGAN DONA-
TION. 
Section 377 of the Public Health Service Act (42 
U.S.C. 274f) is amended to read as follows: 
‘‘PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES 
INCURRED TOWARD LIVING ORGAN DONATION 
‘‘SEC. 377. (a) IN GENERAL.—The Secretary may 
make awards of grants or contracts to States, transplant
centers, qualified organ procurement organizations under 
section 371, or other public or private entities for the pur-
pose of—
‘‘(1) providing for the payment of travel and 
subsistence expenses incurred by individuals toward 
making living donations of their organs (in this sec-
tion referred as ‘donating individuals’); and 
‘‘(2) in addition, providing for the payment of 
such incidental nonmedical expenses that are so in-
curred as the Secretary determines by regulation to 
be appropriate. 
‘‘(b) ELIGIBILITY.—
‘‘(1) IN GENERAL.—Payments under subsection 
(a) may be made for the qualifying expenses of a do-
nating individual only if—
‘‘(A) the State in which the donating indi-
vidual resides is a different State than the 
State in which the intended recipient of the 
organ resides; and 
‘‘(B) the annual income of the intended re-
cipient of the organ does not exceed $35,000 
(as adjusted for fiscal year 2004 and subse-
quent fiscal years to offset the effects of infla-
tion occurring after the beginning of fiscal year 
2003).
‘‘(2) CERTAIN
CIRCUMSTANCES.—Subject to 
paragraph (1), the Secretary may in carrying out 
subsection (a) provide as follows: 
‘‘(A) The Secretary may consider the term 
‘donating individuals’ as including individuals 
who in good faith incur qualifying expenses to-
ward the intended donation of an organ but 
with respect to whom, for such reasons as the 
Secretary determines to be appropriate, no do-
nation of the organ occurs. 
‘‘(B) The Secretary may consider the term 
‘qualifying expenses’ as including the expenses 
of having one or more family members of do-
nating individuals accompany the donating indi-
viduals for purposes of subsection (a) (subject 
to making payment for only such types of ex-
penses as are paid for donating individuals). 
‘‘(c) LIMITATION ON AMOUNT OF PAYMENT.—
‘‘(1) IN GENERAL.—With respect to the geo-
graphic area to which a donating individual travels 
for purposes of subsection (a), if such area is other
than the covered vicinity for the intended recipient 
of the organ, the amount of qualifying expenses for 
which payments under such subsection are made 
may not exceed the amount of such expenses for
which payment would have been made if such area 
had been the covered vicinity for the intended recipi-
ent, taking into account the costs of travel and re-
gional differences in the costs of living. 
‘‘(2) COVERED VICINITY.—For purposes of this 
section, the term ‘covered vicinity’, with respect to 
an intended recipient of an organ from a donating 
individual, means the vicinity of the nearest trans-
plant center to the residence of the intended recipi-
ent that regularly performs transplants of that type 
of organ. 
‘‘(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; or 
‘‘(2) by an entity that provides health services 
on a prepaid basis. 
‘‘(e) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘covered vicinity’ has the mean-
ing given such term in subsection (c)(2). 
‘‘(2) The term ‘donating individuals’ has the 
meaning indicated for such term in subsection 
(a)(1), subject to subsection (b)(2)(A). 
‘‘(3) The term ‘qualifying expenses’ means the 
expenses authorized for purposes of subsection (a), 
subject to subsection (b)(2)(B). 
‘‘(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 
2004 through 2008.’’. 
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 section: 
‘‘PUBLIC AWARENESS; STUDIES AND DEMONSTRATIONS 
‘‘SEC. 377A. (a) PUBLIC AWARENESS.—The Sec-
retary shall (directly or through grants or contracts) carry 
out a program to educate the public with respect to organ 
donation, including the need to provide for an adequate 
rate of such donations. 
‘‘(b) STUDIES
AND DEMONSTRATIONS.—The Sec-
retary may make grants to public and nonprofit private 
entities for the purpose of carrying out studies and dem-
onstration projects with respect to providing for an ade-
quate rate of organ donation. 
‘‘(c) GRANTS TO STATES.—The Secretary may make 
grants to States for the purpose of assisting States in car-
rying out organ donor awareness, public education and 
outreach activities and programs designed to increase the 
number of organ donors within the State, including living 
donors. To be eligible, each State shall—
‘‘(1) submit an application to the Department 
in the form prescribed; 
‘‘(2) establish yearly benchmarks for improve-
ment in organ donation rates in the State; 
‘‘(3) develop, enhance, or expand a State donor 
registry, which shall be available to hospitals, organ 
procurement organizations, tissue banks, eye banks, 
and other States upon a search request; and 
‘‘(4) report to the Secretary on an annual basis 
a description and assessment of the State’s use of 
these grant funds, accompanied by an assessment of 
initiatives for potential replication in other States. 
Funds may be used by the State or in partnership with 
other public agencies or private sector institutions for edu-
cation and awareness efforts, information dissemination, 
activities pertaining to the State donor registry, and other
innovative donation specific initiatives, including living do-
nation. 
‘‘(d) ANNUAL REPORT
TO CONGRESS.—The Sec-
retary shall annually submit to the Congress a report on 
the activities carried out under this section, including pro-
visions describing the extent to which the activities have 
affected the rate of organ donation. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN
GENERAL.—For the purpose of car-
rying out this section, there are authorized to be ap-
propriated $15,000,000 for fiscal year 2004, and 
such sums as may be necessary for each of the fiscal 
years 2005 through 2008. Such authorization of ap-
propriations is in addition to any other authoriza-
tions of appropriations that are available for such 
purpose. 
‘‘(2) STUDIES AND DEMONSTRATIONS.—Of the 
amounts appropriated under paragraph (1) for a fis-
cal year, the Secretary may not obligate more than 
$2,000,000 for carrying out subsection (b).’’. 
SEC. 5. EFFECTIVE DATE. 
The amendments made by this Act take effect on the 
date of the enactment of this Act.
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