[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3885 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 3885

    To amend the Public Health Service Act to revise and extend the 
      programs relating to organ procurement and transplantation.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 9, 2000

 Mr. LaHood (for himself and Mr. Rush) introduced the following bill; 
            which was referred to the Committee on Commerce

_______________________________________________________________________

                                 A BILL


 
    To amend the Public Health Service Act to revise and extend the 
      programs relating to organ procurement and transplantation.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Organ Donation and Transplantation 
Improvements Act of 2000''.

SEC. 2. FINDINGS.

    (a) In General.--The Congress finds as follows:
            (1) It is in the public interest to maintain and improve a 
        system for promoting and supporting a central network to assure 
        the fair and effective distribution of organs among patients on 
        the national waiting list, and to assure quality and facilitate 
        collaboration among network members and individual medical 
        practitioners participating in the network activities.
            (2) The Organ Procurement and Transplantation Network 
        (``Network'') was created in 1984 by the National Organ 
        Transplant Act in order to facilitate an equitable allocation 
        of organs among patients.
            (3) The Federal Government should continue to provide 
        Federal oversight of the Network and is responsible for 
        protecting the public's health care interest and assuring that 
        the policies of the Network meet the goals established by this 
        Act.
            (4) The responsibility for developing, establishing, and 
        maintaining medical criteria and standards for organ 
        procurement and transplantation is a function of the Network 
        established under contract with the Federal Government.
            (5) The Federal Government is responsible for assuring that 
        the efforts of the Network serve the patients and donor 
        families in the procurement and distribution of organs.
            (6) The Federal Government should take immediate action to 
        improve organ donation rates and increase the number of organs 
        available for transplantation.
            (7) There is a significant disparity between the number of 
        organ donors and the number of individuals waiting for organ 
        transplants so that it is in the public's best interest to have 
        a system of organ allocation that is fair and equitable to all 
        individuals.
    (b) Sense of Congress Regarding Organ Donation.--The Congress finds 
as follows:
            (1) The factors that impact organ donation rates are 
        complex and require a multifaceted approach to increase organ 
        donation rates.
            (2) The Federal Government should lead the national effort 
        to increase organ donation and develop programs with the 
        transplant community to research and implement a best practices 
        approach to increasing organ donation.
            (3) A generous contribution has been made by each living 
        individual who has donated an organ to save a life.

SEC. 3. ORGAN PROCUREMENT ORGANIZATIONS.

    Section 371 of the Public Health Service Act (42 U.S.C. 273) is 
amended to read as follows:

``SEC. 371. ORGAN PROCUREMENT ORGANIZATIONS.

    ``(a) Authority of the Secretary.--
            ``(1) The Secretary may make grants for the planning of 
        qualified organ procurement organizations described in 
        subsection (b) of this section.
            ``(2) The Secretary may make grants for the establishment, 
        initial operation, consolidation, and expansion of qualified 
        organ procurement organizations described in subsection (b) of 
        this section.
            ``(3) The Secretary may make grants to, and enter into 
        contracts with, qualified organ procurement organizations 
        described in subsection (b) of this section and other nonprofit 
        private entities for the purpose of carrying out special 
        projects designed to increase the number of organ donors.
    ``(b) Qualified Organizations.--
            ``(1) A qualified organ procurement organization for which 
        grants may be made under subsection (a) of this section is an 
        organization which, as determined by the Secretary, will carry 
        out the functions described in paragraph (2) and--
                    ``(A) is a nonprofit entity;
                    ``(B) has accounting and other fiscal procedures 
                (as specified by the Secretary) necessary to assure the 
                fiscal stability of the organization;
                    ``(C) has an agreement with the Secretary to be 
                reimbursed under title XVIII of the Social Security Act 
                for the procurement of kidneys;
                    ``(D) notwithstanding any other provision of law, 
                has met the other requirements of this subsection and 
                has been certified or recertified by the Secretary as 
                meeting the performance standards to be a qualified 
                organ procurement organization through a process 
                which--
                            ``(i) granted certification or 
                        recertification within the previous 4 years 
                        with such certification in effect as of October 
                        1, 2000, and remaining in effect through the 
                        earlier of--
                                    ``(I) January 1, 2002; or
                                    ``(II) the completion of 
                                recertification under the requirements 
                                of clause (ii); or
                            ``(ii) is defined through regulations 
                        promulgated by the Secretary not later than 
                        January 1, 2002, which--
                                    ``(I) require recertification of 
                                qualified organ procurement 
                                organizations not more frequently than 
                                once every 4 years;
                                    ``(II) rely on performance measures 
                                that are based on empirical evidence of 
                                organ donor potential and other related 
                                factors in each service area of the 
                                qualified organ procurement 
                                organizations;
                                    ``(III) provide for the filing and 
                                approval of a corrective action plan by 
                                a qualified organ procurement 
                                organization that fails to meet the 
                                performance standards and a grace 
                                period of not less than 2 years during 
                                which such organization can implement 
                                the corrective action plan without risk 
                                of decertification; and
                                    ``(IV) provide for a qualified 
                                organ procurement organization to 
                                appeal a decertification to the 
                                Secretary on substantive and procedural 
                                grounds;
                    ``(E) has procedures to obtain payment for nonrenal 
                organs provided to transplant centers;
                    ``(F) has a defined service area that is of 
                sufficient size to assure maximum effectiveness in the 
                procurement of organs;
                    ``(G) has a director and other such staff, 
                including the organ donation coordinators and organ 
                procurement specialists necessary to effectively obtain 
                organs from donors in its service area; and
                    ``(H) has a board of directors or an advisory board 
                which--
                            ``(i) is composed of--
                                    ``(I) members who represent 
                                hospital administrators, intensive care 
                                or emergency room personnel, tissue 
                                banks, and voluntary health 
                                organizations in its service area;
                                    ``(II) members who represent the 
                                public residing in such area;
                                    ``(III) a physician with knowledge, 
                                experience, or skill in the field of 
                                histocompatibility or an individual 
                                with a doctorate degree in biological 
                                science with knowledge, experience, or 
                                skill in the field of 
                                histocompatibility;
                                    ``(IV) a physician with knowledge 
                                or skill in the field of neurology; and
                                    ``(V) from each transplant center 
                                in its service area, a member who is a 
                                surgeon who has practicing privileges 
                                in such center and who performs organ 
                                transplant surgery;
                            ``(ii) has the authority to recommend 
                        policies for the procurement of organs and the 
                        other functions described in paragraph (2); and
                            ``(iii) has no authority over any other 
                        activity of the organization.
            ``(2) An organ procurement organization shall--
                    ``(A) have effective agreements, to identify 
                potential organ donors, with all of the hospitals and 
                other health care entities in its service area which 
                have facilities for organ donation;
                    ``(B) conduct and participate in systematic 
                efforts, including professional education, to acquire 
                all usable organs from potential donors;
                    ``(C) arrange for the acquisition and preservation 
                of donated organs and provide quality standards for the 
                acquisition of organs which are consistent with the 
                standards adopted by the Organ Procurement and 
                Transplantation Network under section 372(b)(2)(E), 
                including arranging for testing with respect to 
                preventing the acquisition of organs that are infected 
                with the etiologic agent for acquired immune deficiency 
                syndrome;
                    ``(D) arrange for the appropriate tissue typing of 
                donated organs;
                    ``(E) have a system to distribute organs equitably 
                among transplant patients according to the requirements 
                established by the Organ Procurement and 
                Transplantation Network, and approved by the Secretary, 
                under section 372(c);
                    ``(F) provide or arrange for the transportation of 
                donated organs to transplant centers;
                    ``(G) have arrangements to coordinate its 
                activities with transplant centers in its service area;
                    ``(H) participate in the Organ Procurement and 
                Transplantation Network established under section 372;
                    ``(I) have arrangements to cooperate with tissue 
                banks for the retrieval, processing, preservation, 
                storage, and distribution of tissues as may be 
                appropriate to assure that all usable tissues are 
                obtained from potential donors;
                    ``(J) evaluate annually the effectiveness of the 
                organization in acquiring potentially available organs; 
                and
                    ``(K) assist hospitals in establishing and 
                implementing protocols for making routine inquiries 
                about organ donations by potential donors.''.

SEC. 4. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK.

    Section 372 of the Public Health Service Act (42 U.S.C. section 
274) is amended to read as follows:

``SEC. 372. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK.

    ``(a) Contract Authority of Secretary.--The Secretary shall by 
contract provide for the establishment and operation of an Organ 
Procurement and Transplantation Network which meets the requirements of 
subsection (b) of this section.
    ``(b) Functions.--
            ``(1) The Organ Procurement and Transplantation Network 
        shall carry out the functions described in paragraph (2) and 
        shall--
                    ``(A) be operated by a private nonprofit entity 
                that has an expertise in organ procurement and 
                transplantation; and
                    ``(B) have a board of directors--
                            ``(i) that includes representatives of 
                        organ procurement organizations (including 
                        organizations that have received grants under 
                        section 371), transplant centers, voluntary 
                        health associations, transplant recipients or 
                        their family members, donor family members, and 
                        the general public; and
                            ``(ii) that shall establish an executive 
                        committee and other committees, whose 
                        chairpersons shall be selected to ensure 
                        continuity of the board.
            ``(2) The Organ Procurement and Transplantation Network 
        shall--
                    ``(A) establish in one location--
                            ``(i) a national list of individuals who 
                        need organs; and
                            ``(ii) a national system, through the use 
                        of computers and in accordance with established 
                        medical criteria, to match organs and 
                        individuals included on the list, especially--
                                    ``(I) individuals whose immune 
                                system makes it difficult for them to 
                                receive organs; and
                                    ``(II) individuals considered to 
                                have the highest medical urgency;
                    ``(B) establish membership criteria for hospitals 
                and other health care entities performing organ 
                transplants;
                    ``(C) maintain a twenty-four-hour telephone service 
                to facilitate matching organs with individuals included 
                in the list;
                    ``(D) assist organ procurement organizations in the 
                nationwide distribution of organs equitably among 
                transplant patients;
                    ``(E) adopt and use standards of quality for the 
                acquisition and transportation of donated organs, 
                including standards for preventing the acquisition of 
                organs that are infected with the etiologic agent for 
                acquired immune deficiency syndrome;
                    ``(F) prepare and distribute, on a national basis, 
                samples of blood sera from individuals who are included 
                on the list and whose immune system makes it difficult 
                for them to receive organs, in order to facilitate 
                matching the compatibility of such individuals with 
                organ donors;
                    ``(G) coordinate, as appropriate, the 
                transportation of organs from organ procurement 
                organizations to transplant centers;
                    ``(H) provide information to physicians and other 
                health professionals regarding organ donation;
                    ``(I) collect, analyze, and publish data concerning 
                organ donation and transplants;
                    ``(J) carry out studies and demonstration projects 
                for the purpose of improving procedures for organ 
                procurement and allocation;
                    ``(K) work actively to increase the supply of 
                donated organs;
                    ``(L) submit to the Secretary an annual report 
                containing information on the comparative costs and 
                patient outcomes at each transplant center affiliated 
                with the organ procurement and transplantation network; 
                and
                    ``(M) submit to the Secretary an annual report 
                containing such financial information, as determined by 
                the Secretary, to be necessary to evaluate the cost of 
                operating the Organ Procurement and Transplantation 
                Network.
    ``(c) Organ Allocation.--
            ``(1) The Organ Procurement and Transplantation Network 
        shall develop organ specific policies (including combinations 
        of organs, such as for kidney-pancreas transplants), subject to 
        the review of the Secretary, for the equitable allocation of 
        cadaveric organs to individuals on the national waiting list.
            ``(2) Standardized minimum listing criteria for including 
        individuals on the national list shall be established and, to 
        the extent possible, shall--
                    ``(A) contain explicit thresholds for listing a 
                patient;
                    ``(B) include thresholds to avoid futile 
                transplants or the wasting of organs;
                    ``(C) be expressed through objective and measurable 
                medical criteria; and
                    ``(D) be reviewed periodically and revised as 
                appropriate.
            ``(3) Where appropriate for the specific organ, transplant 
        candidates shall--
                    ``(A) be grouped by status categories from most to 
                least medically urgent with--
                            ``(i) sufficient categories to avoid 
                        grouping together individuals with 
                        substantially different medical urgency;
                            ``(ii) explicit thresholds for 
                        differentiating among patients; and
                            ``(iii) explicit standards for the movement 
                        of individuals among the status categories;
                    ``(B) be expressed through objective and measurable 
                medical criteria; and
                    ``(C) be reviewed periodically and revised as 
                appropriate.
            ``(4) Organ allocation policies and procedures shall be 
        established in accordance with sound medical judgment and 
        shall--
                    ``(A) be designed and implemented to allocate 
                organs among transplant candidates--
                            ``(i) in order of decreasing medical 
                        urgency status;
                            ``(ii) over the largest geographic area so 
                        that neither place of residence nor place of 
                        listing shall be a major determinant; and
                            ``(iii) so as to maintain organ viability 
                        and avoid organ wastage; and
                    ``(B) be reviewed periodically and revised as 
                appropriate.
            ``(5) Where medical urgency is not an appropriate 
        measurement for organ allocation, policies and procedures shall 
        be established in accordance with sound medical judgment and 
        shall be designed and implemented--
                    ``(A) to allocate organs among individuals on the 
                waiting list based upon their time on the waiting list; 
                and
                    ``(B) to reduce the inter-transplant program 
                waiting time variance to be as small as possible.
    ``(d) Authority of the Secretary.--The policies and rules 
established by the Organ Procurement and Transplantation Network shall 
be subject to review and approval by the Secretary. The Secretary 
shall--
            ``(1) in consultation with the Organ Procurement and 
        Transplantation Network, develop mechanisms to promote and 
        review compliance with the requirements of this section;
            ``(2) establish and approve all fees, dues, or similar 
        costs charged in the operation of the Organ Procurement and 
        Transplantation Network;
            ``(3) establish procedures for receiving from interested 
        persons critical comments relating to the manner in which the 
        Organ Procurement and Transplantation Network is carrying out 
        the duties of the Network under subsection (b) of this section; 
        and
            ``(4) take such action, as determined by the Secretary, to 
        enforce the requirements of this section as well as the 
        requirements under title XVIII of the Social Security Act.
    ``(e) National Transplant Advisory Board.--
            ``(1) The Secretary shall provide for the establishment of 
        a National Organ Transplant Advisory Board (referred to in this 
        subsection as the `Board').
            ``(2) The National Organ Transplant Advisory Board shall 
        carry out the functions described in paragraph (3) and shall be 
        comprised of individuals that--
                    ``(A) include a broad spectrum of representatives 
                of the medical and scientific community, including 
                epidemiologists and health service researchers, as well 
                as representatives from organ procurement organizations 
                and the community of transplant patients, family 
                members and donor families;
                    ``(B) are selected by the Secretary in consultation 
                with the Organ Procurement and Transplantation Network; 
                and
                    ``(C) serve terms of not less than three years.
            ``(3) The National Organ Transplant Advisory Board shall 
        assist the Secretary in ensuring that the Organ Procurement and 
        Transplantation Network is grounded on the best available 
        medical science and is effective and equitable as possible and 
        shall--
                    ``(A) at the request of the Secretary, review the 
                policies and rules of the Organ Procurement and 
                Transplantation Network;
                    ``(B) at the request of the Secretary, review and 
                consider policies and regulations affecting organ 
                transplantation developed by the Secretary;
                    ``(C) advise and propose to the Secretary policies, 
                rules, and regulations affecting organ procurement and 
                transplantation;
                    ``(D) advise the Secretary with respect to comments 
                received by the Secretary under section 372(d)(3) of 
                this title;
                    ``(E) meet at the request of the Secretary, but not 
                less than two times every year; and
                    ``(F) elect a Chairperson and Vice-chairperson as 
                well as any other officers as determined by the Board.
            ``(4) For the purpose of carrying out this subsection, 
        there are authorized to be appropriated $500,000 for each of 
        the fiscal years 2000 through 2005.''.

SEC. 5. SCIENTIFIC REGISTRY.

    Section 373 of the Public Health Service Act (42 U.S.C. 274a) is 
amended to read as follows:

``SEC. 373. SCIENTIFIC REGISTRY.

    ``The Secretary shall, by grant or contract, develop and maintain a 
scientific registry of the recipients of organ transplants. The 
registry shall include such information respecting patients and 
transplant procedures as the Secretary deems necessary to an ongoing 
evaluation to the scientific and clinical status of organ 
transplantation. The registry shall also include such information 
respecting both donors and patients in transplants involving living 
donors. The Secretary shall prepare for inclusion in the report under 
section 376 an analysis of information derived from the registry.''.

SEC. 6. ADMINISTRATION.

    Section 375 of the Public Health Service Act (42 U.S.C. section 
274c) is amended to read as follows:

``SEC. 375. ADMINISTRATION.

    ``The Secretary shall designate and maintain an identifiable 
administrative unit in the Public Health Service to--
            ``(1) administer this part and coordinate with organ 
        procurement activities under title XVIII of the Social Security 
        Act;
            ``(2) administer and coordinate programs, as determined by 
        the Secretary, to increase organ donation rates;
            ``(3) provide technical assistance to organ procurement 
        organizations, the Organ Procurement and Transplantation 
        Network established under section 372, and other entities in 
        the health care system involved in organ donations, 
        procurements, and transplants; and
            ``(4) provide information--
                    ``(A) to patients, their families, and their 
                physicians about transplantation; and
                    ``(B) to patients and their families about 
                resources available nationally and in each State, and 
                the comparative costs and patient outcomes at each 
                transplant center affiliated with the organ procurement 
                and transplantation network, in order to assist the 
                patients and families with the costs associated with 
                transplantation.''.

SEC. 7. ADDITIONAL AMENDMENTS.

    (a) Part H.--Part H of title III of the Public Health Service Act 
(42 U.S.C. 273 et seq.) is amended--
            (1) in section 374--
                    (A) in subsection (b)(1), by striking all after 
                ``organization'' and inserting the following: ``and 
                other organizations for the purpose of increasing the 
                supply of transplantable organs.''; and
                    (B) in subsection (b)(2), by striking all after 
                ``two years.'';
            (2) in section 376, by striking ``Committee on Energy and 
        Commerce'' and inserting ``Committee on Commerce''; and
            (3) by striking section 377.
    (b) Part J.--Part J of title III of the Public Health Service Act 
(42 U.S.C. 274k et seq.) is amended by redesignating sections 379 
through 379(a) as sections 380 through 380(a).

SEC. 8. PAYMENT OF TRAVEL AND SUBSISTENCE EXPENSES INCURRED TOWARD 
              LIVING ORGAN DONATION.

    Part H of title III of the Public Health Service Act is amended by 
inserting after section 376 the following section:

``SEC. 377. TRAVEL AND SUBSISTENCE PAYMENTS FOR LIVING ORGAN DONATION.

    ``(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 purpose of--
            ``(1) providing for the payment of travel and subsistence 
        expenses incurred by individuals toward making living donations 
        of their organs (in this section referred to as `donating 
        individuals'); and
            ``(2) in addition, providing for the payment of such 
        incidental nonmedical expenses that are so incurred 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 donating individual only 
        if--
                    ``(A) the State in which the donating individual 
                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 recipient 
                of the organ does not exceed $35,000 (as adjusted for 
                fiscal year 2002 and subsequent fiscal years to offset 
                the effects of inflation occurring after the beginning 
                fiscal year 2001).
            ``(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 toward the intended donation 
                of an organ but with respect to whom, for such reason 
                as the Secretary determines to be appropriate, no 
                donation 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 donating individuals accompany 
                the donating individuals for purposes of subsection (a) 
                (subject to making payment for only such types of 
                expenses as are paid for donating individuals).
    ``(c) Limitation on Amount of Payment.--
            ``(1) In general.--With respect to the geographic area to 
        which a donating individual travels for purposes of section 
        (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 recipient, taking into account the costs of travel 
        and regional differences in the cost 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 transplant center to the residence of the intended 
        recipient 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 agrees that the 
award will not be expended to pay the qualifying expenses of a donating 
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 meaning given 
        such term in subsection (c)(2).
            ``(2) The term `donating individual' 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 fiscal years 2000 through 2005.''.

SEC. 9. PROGRAMS AND DEMONSTRATION PROJECTS TO INCREASE ORGAN DONATION.

    Part H of title III of the Public Health Service Act is amended by 
inserting after section 377 the following section:

``SEC. 378. INITIATIVES TO INCREASE ORGAN DONATION.

    ``(a) Public Awareness.--The Secretary shall (directly or through 
grants or contracts) carry out a program to educate the public with 
respect to organ donation.
    ``(b) Studies and Demonstrations.--The Secretary may make grants to 
public and nonprofit entities for the purpose of carrying out studies 
and demonstration projects with respect to increasing rates of organ 
donation. The Secretary shall--
            ``(1) give priority to those studies and demonstration 
        projects that are founded upon a `best practices' approach to 
        increasing organ donation consent rates;
            ``(2) give priority to those geographic areas with lower 
        organ donation consent rates, especially among minorities;
            ``(3) provide assistance to qualified organ procurement 
        organizations described under section 371 to implement programs 
        and projects, that as determined by Secretary through studies 
        and demonstration projects, have proven to be effective in 
        increasing organ donation rates; and
            ``(4) provide assistance to the study and consideration of 
        `presumed consent' as an opportunity to increase organ donation 
        rates.
    ``(c) Grants to States.--The Secretary may make grants to states 
for the purpose of carrying out public education and outreach programs 
designed to increase the number of organ donors within the state. To be 
eligible, each state shall--
            ``(1) submit an application to the Secretary, in such form 
        as prescribed by the Secretary; and
            ``(2) establish yearly benchmarks for improvement in organ 
        donation rates in the State.
    ``(d) Congressional Medal.--
            ``(1) The Secretary shall design a bronze medal with 
        suitable emblems, devices, and inscriptions, to be determined 
        by the Secretary, to commemorate organ donors and their 
        families.
            ``(2) Any organ donor, or the family of any organ donor, 
        shall be eligible for a medal.
            ``(3) The Secretary shall direct the Organ Procurement and 
        Transplantation Network, established under section 372, to--
                    ``(A) establish an application procedure requiring 
                the relevant organ procurement organizations, described 
                in section 371 of this title, through which an 
                individual of their family made an organ donation, to 
                submit documentation supporting the eligibility of that 
                individual or their family to receive a medal.
                    ``(B) determine through the documentation provided, 
                and, if necessary, independent investigation, whether 
                the individual or family is eligible to receive a 
                medal.
            ``(4) The Secretary shall make suitable arrangements as 
        necessary with the Secretary of the Treasury to strike and 
        deliver the medals described in paragraph (3).
            ``(5) The Secretary shall provide for the presentation to 
        the relevant organ procurement organizations all medals struck 
        pursuant to this section to individuals or families that, in 
        accordance with paragraph (3), the Organ Procurement and 
        Transplantation Network has determined eligible to receive 
        medals.
            ``(6)(A) Except as provided in subparagraph (B), only 1 
        medal may be presented to a family under paragraph (5). Such 
        medal shall be presented to the donating family member, or in 
        the case of a deceased donor, the family member who signed the 
        consent form authorizing, or who otherwise authorized, the 
        donation of the organ involved.
            ``(B) In the case of a family in which more than 1 member 
        is an organ donor, an additional medal may be presented to each 
        such organ donor or their family.
            ``(7) The Secretary or the Organ Procurement and 
        Transplantation Network may provide duplicates of a medal--
                    ``(A) to any recipient of a medal under subsection 
                (4) under such regulation as the Secretary may issue; 
                and
                    ``(B) the cost of which shall be sufficient to 
                cover the costs of such duplicates.
            ``(8) The medals struck pursuant to the section are 
        national medals for purposes of section 5111 of title 31, 
        United States Code.
            ``(9) No provision of law governing procurement or public 
        contracts shall be applicable to the procurement of goods or 
        services necessary for carrying out the provisions of this 
        section.
            ``(10)(A) The Secretary of the Treasury may enter into an 
        agreement with the Organ Procurement and Transplantation 
        Network to collect funds to offset expenditures relating to the 
issuance of medals authorized under this section.
            ``(B)(i) Except as provided in clause (ii), all funds 
        received by the Organ Procurement and Transplantation Network 
        for this purpose shall be promptly paid to the Secretary of the 
        Treasury.
            ``(ii) Not more than 5 percent of any funds received under 
        this subsection shall be used to pay administrative costs 
        incurred by the Organ Procurement and Transplantation Network 
        as a result of an agreement established under this subsection.
            ``(C) Notwithstanding any other provision of law--
                    ``(i) all amounts received by the Secretary of the 
                Treasury under subsection (9)(A)(i) shall be deposited 
                in the Numismatic Public Enterprise Fund, as described 
                in section 5134 of title 31, United States Code; and
                    ``(ii) the Secretary of the Treasury shall charge 
                such fund with all expenditures relating to the 
                issuance of medals authorized under this section.
            ``(D) A one-time amount not to exceed $55,000 shall be 
        provided to the Organ Procurement and Transplantation Network 
        to cover initial start-up costs to be paid back in full within 
        3 years of the date of enactment of this section from funds 
        received under this subsection.
            ``(11) For the purposes of this section, the term ``organ'' 
        means the human kidney, liver, heart, lung, pancreas, and any 
        other human organ (other than corneas and eyes) specified by 
        regulation by the Secretary.
            ``(12) This section shall be effective for the 5-year 
        period beginning on the date of the enactment of this section.
    ``(e) Annual Report to Congress.--The Secretary shall submit to the 
Congress a report on the activities carried out under this section, 
including provisions describing the extent to which the activities have 
affected the rate of organ donation.
    ``(f) Authorization of Appropriations.--
            ``(1) In general.--For the purpose of carrying out this 
        section, there are authorized to be appropriated $10,000,000 
        for fiscal year 2000, and such sums as may be necessary for 
        each of the fiscal years 2001 through 2005. Such authorization 
        of appropriations is in addition to any other authorizations of 
        appropriations that are available for such purpose.
            ``(2) Public Awareness.--Of the amounts appropriated under 
        paragraph (1) for a fiscal year, the Secretary may not obligate 
        more than $2,000,000 for carrying out subsection (a).''.

SEC. 10. AUTHORIZATION OF APPROPRIATIONS

    Part H of title III of the Public Health Service Act is amended by 
inserting after section 378 the following section:

``SEC. 379. AUTHORIZATION OF APPROPRIATIONS FOR ORGAN PROCUREMENT AND 
              TRANSPLANTATION NETWORK.

    ``For the purpose of providing for the Organ Procurement and 
Transplantation Network under section 372, and for the Scientific 
Registry under section 373, there are authorized to be appropriated 
$4,000,000 for fiscal year 2000, and such sums as may be necessary for 
each of fiscal years 2001 through 2005.''.

SEC. 11. EFFECTIVE DATE.

    The amendments made by this Act take effect October 1, 2000, or 
upon the date of enactment of this Act, whichever occurs later.
                                 <all>