[Congressional Record Volume 147, Number 29 (Wednesday, March 7, 2001)]
[House]
[Pages H672-H677]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
ORGAN DONATION IMPROVEMENT ACT OF 2001
Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 624) to amend the Public Health Service Act to promote organ
donation, as amended.
The Clerk read as follows:
H.R. 624
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Organ Donation Improvement
Act of 2001''.
SEC. 2. SENSE OF CONGRESS.
(a) Public Awareness of Need for Organ Donation.--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 pledging 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 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 technology that
have enabled organ transplantation with organs donated by
living individuals to become a viable treatment option for an
increasing number of patients.
SEC. 3. PAYMENT 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:
``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 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 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 of 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 reasons 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
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 recipient,
taking into account the costs of travel and regional
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 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
involved 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 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 2002
through 2006.''.
SEC. 4. PUBLIC AWARENESS; STUDIES AND DEMONSTRATIONS.
Part H of title III of the Public Health Service Act (42
U.S.C. 273 et seq.) is amended by inserting after section 377
the following section:
``public awareness; studies and demonstrations
``Sec. 377A. (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,
including the need to provide for an adequate rate of such
donations.
``(b) Studies and Demonstrations.--The Secretary may make
grants to public and nonprofit private entities for the
purpose of carrying out studies and demonstration projects
with respect to providing for an adequate rate of organ
donation.
``(c) Grants to States.--The Secretary may make grants to
States for the purpose of assisting States in carrying 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 improvement 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, 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
[[Page H673]]
sector institutions for education and awareness efforts,
information dissemination, activities pertaining to the State
organ donor registry, and other innovative donation specific
initiatives, including living donation.
``(d) Annual Report to Congress.--The Secretary shall
annually 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.
``(e) Authorization of Appropriations.--
``(1) In general.--For the purpose of carrying out this
section, there are authorized to be appropriated $15,000,000
for fiscal year 2002, and such sums as may be necessary for
each of the fiscal years 2003 through 2006. Such
authorization of appropriations is in addition to any other
authorizations of appropriations that is available for such
purpose.
``(2) Studies and demonstrations.--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 (b).''.
SEC. 5. EFFECTIVE DATE.
The amendments made by this Act take effect on the date of
the enactment of this Act.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Florida (Mr. Bilirakis) and the gentleman from Ohio (Mr. Brown) each
will control 20 minutes.
The Chair recognizes the gentleman from Florida (Mr. Bilirakis).
General Leave
Mr. BILIRAKIS. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days within which to revise and extend their
remarks on H.R. 624 and to insert extraneous material on the bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Florida?
There was no objection.
Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may
consume.
I am pleased, Mr. Speaker, that the House is today considering H.R.
624, the Organ Donation Improvement Act of 2001. I want to thank my
committee colleagues, the gentleman from Wisconsin (Mr. Barrett) and
the gentleman from Ohio (Mr. Brown), the subcommittee ranking member,
for their help in drafting this bill.
The full Committee on Energy and Commerce approved H.R. 624 on
February 28 by unanimous vote, which reflects the bipartisanship nature
of this initiative.
I also want to thank Secretary Tommy Thompson for making organ
donation a top priority for his first 100 days in office. He has
recognized the serious nature of this growing problem and intends to
act quickly to increase organ donation efforts across the country. In
fact, I received a letter from Secretary Thompson indicating his
support for H.R. 624 and his intent to work with Congress to increase
organ donation in the future.
Mr. Speaker, during the latter part of the last Congress, we had the
legislation going through the body which would have done what we are
doing in this legislation but also had established allocation
procedures. It was very controversial; and as a result of that, the
legislation was not able to move.
What we have done in this legislation in a bipartisan basis was to
pull out all of the noncontroversial very, very significant areas of
that legislation and put them into this and left out completely the
allocation procedures, which were controversial. I think that is very
important that all of the Members realize that this is a different
piece of legislation with no controversial areas at all.
{time} 1300
Continuing, Mr. Speaker, nationwide we do not have enough organs for
patients who need a transplant. During the 1990s, the number of
patients waiting for organ transplants rose more than five times as
fast as the number of transplant operations. In 1999, more than 20,000
transplants were performed, but the transplant waiting list exceeded
70,000 patients. As a result, more than 50,000 patients did not receive
the transplants they needed.
With modern technology and the success of organ transplants, many of
these deaths are preventable. Unfortunately, despite the generosity and
self-sacrifice of thousands of donors who have given an organ to a
patient in need, the supply of organs continues to fall short of the
need. In my own State of Florida, the transplant waiting lists continue
to grow and patients continue to wait.
What is most unfortunate, however, is the number of people who have
died while on one of these transplant waiting lists. In 1999, in the
State of Florida alone, 65 patients died while waiting for a liver
transplant, 35 patients died while waiting for a heart transplant, 17
patients died while waiting for a lung transplant, and 91 patients died
while waiting for a kidney transplant. So we must act to these
preventable deaths by increasing the supply of organs and discussing
the gift of life, as the gentlewoman from Florida (Mrs. Thurman) said,
with friends and family.
H.R. 624 recognizes the contributions made by living individuals who
have donated organs to save lives. It also acknowledges the advances in
medical technology that have made transplantation a viable treatment
option for an increasing number of patients. Significantly, H.R. 624
directs the Secretary of Health and Human Services to carry out
programs to educate the public with respect to organ donation. This
bill also authorizes grants to cover the costs of travel and
subsistence expenses for individuals who make living donations of their
organs.
I am confident that these measures will provide the necessary
incentives for Americans considering organ donation and increase the
supply of organs. I urge all my colleagues to join me today in
supporting passage of H.R. 624, the Organ Donation Improvement Act.
Mr. Speaker, I reserve the balance of my time.
Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, this bill complements the resolution we just considered,
and I would again like to thank the gentleman from Wisconsin (Mr.
Barrett), the gentleman from Florida (Mr. Bilirakis), and the
gentlewoman from Florida (Mrs. Thurman) for their work on this
legislation.
In 1999, nearly 75,000 people were on waiting lists for organ
transplants; yet less than 22,000 of these 75,000 received transplants.
Nearly 12 people die every day while waiting for a transplant. The
question is how do we identify and how do we remove barriers to
donation, narrowing the significant gap between transplant candidates
and available organs?
Public awareness is part of the problem. Providing assistance to
living organ donors is another step. H.R. 624 would set both of these
strategies in motion. The authors have been clear. This bill is not an
exhaustive response to the donor organ shortfall. This bill, however,
to its credit, is a starting point in implementing good ideas and in
signaling congressional interest in an issue significant to all of us.
Organ donation is such an amazing act of giving, one that delivers
hope and health and life to thousands of patients a year. The fact that
H.R. 624 represents the first step in a broader effort does not
minimize its importance. I fully support its passage.
Mr. Speaker, I yield 2 minutes to the gentlewoman from Florida (Mrs.
Thurman), who has been a leader on this and other organ donation
issues.
Mrs. THURMAN. Mr. Speaker, I thank the gentleman for yielding me this
time.
Before I start in on a little bit of what we are talking about today,
one of the things we probably ought to do first and foremost is thank
all of the men and women out there today that have made that choice and
have made a difference in people's lives, because without their
generous donation we would not have this opportunity to even be talking
about this and the technology and what has happened over several years.
So I would like to just take a moment to thank and to express to
those family members, whether because of a loss or because of a
connection with another family member, how much we appreciate what they
have given already in this debate.
Today, what we are talking about is a resolution, and I commend our
chairman for this and also the gentleman from Ohio (Mr. Brown). As the
chairman said, this was part of a piece of legislation last year that
kind of got tied up in some allocation issues, but the issue in this
one is so important because this actually helps us with expensing. So
that if we have a living
[[Page H674]]
donor, we can provide an opportunity for them to give the gift that
they would like to give. So it is a very simple, direct kind of program
that if one is willing to help and is willing to donate, that we are
going to help in that regard as well.
The only other thing I would say is, I would like the chairman just
to consider a second part of this piece of legislation that we
introduced last year, which is the idea of when somebody is working, to
be able to give them some time off where it does not hurt them in the
workplace. Because without that time, it is very difficult for them.
Even though they may be getting some of their expenses covered, they do
have to take time off of work to be able to go and do this. So I just
hope at sometime we can look at that issue.
But certainly my praises are to this committee and to this Congress
for giving us this gift of life.
Mr. BROWN of Ohio. Mr. Speaker, I yield 4 minutes to the gentleman
from Wisconsin (Mr. Barrett), who has been very involved in this issue
during his time in Congress.
Mr. BARRETT of Wisconsin. Mr. Speaker, I thank the gentleman for
yielding me this time, and I want to compliment the gentleman from
Florida (Mr. Bilirakis), the gentleman from Ohio (Mr. Brown), and the
others that have been so active on this issue. I think this is an issue
that I think ultimately does have bipartisan support and we can all
work together on.
In 1999, David Raine of Racine, Wisconsin, was put on a waiting list
for a kidney. The clock was ticking, and his health was declining. It
used to be that one family's saving grace was another family's tragedy,
as organs were generally donated from the recently deceased. Though
organ donation from the deceased is still the chief source of organ
donations, there is an increasing number of organs donated from a
healthy individual who is compatible to a patient in need. Though
typically this type of transplant is done with kidneys, advances are
being made in the transplantation of other organs, such as lungs and
livers.
For David Raine, living donation saved him. As he describes it, an
angel came into his life. Leslie Kallenbach, a fellow parishioner at
David's church, offered her own kidney to him. Tests determined she was
a perfect match; and in January of 2001, David and Leslie underwent
surgeries at Saint Luke's Medical Center in Milwaukee. One of Leslie's
kidneys was successfully transplanted to David by Dr. William
Stevenson, and David Raine said he felt energy return to his body
almost immediately. Both recovered without complication.
This is a happy ending that I wish was found in every transplant
patient's story. Sadly, it is not. Fourteen people die each day because
the organ they need is not available to them. The gap between organ
transplants and the number of patients waiting for organs more than
doubled in the 1990s, according to a recent report by UNOS. On February
24, the UNOS national waiting list had 74,800 patients awaiting organs.
Over half of those are waiting for kidneys.
In Wisconsin alone there are currently more than 1,500 people on
organ waiting lists. Most of them are waiting kidneys. I mention
kidneys in particular because through the advancement of medicine,
living donations of kidneys are the most commonplace of all living
donations.
The Organ Donation Improvement Act promotes living donation.
According to UNOS, the number of living organ donors more than doubled
from 1990 to 1999. The selfless humanity exhibited by living donors is
recognized by this bill, as is the progress made in medical technology
that has enabled living donor transplants, like the one from Leslie
Kallenbach to David Raine.
This measure also provides financial assistance to States to develop
and grow donor registries and to connect these registries to organ
procurement organizations and hospitals. The bill also helps donors
defray the costs associated with their testing and donations.
I am proud to say that Wisconsin is a leader in organ donation and
transplant surgery among the States. Wisconsin's medical centers accept
significantly greater numbers of organs for transplant than the
national average. I will continue to fight to advance this cause and do
whatever is necessary to share Wisconsin's success with the rest of the
Nation.
Though I am pleased to see such swift action on this bill by the
Committee on Commerce and now by my colleagues in the House, this
cannot be the last word on organs. Our job is far from done. I
appreciate the heartfelt support for these efforts by Health and Human
Services Secretary Thompson, and I hope to work with him to develop a
network of State donor registries so that the stories of those people
who are waiting for the gift of life might have the same happy ending
as David Raine.
Mr. BILIRAKIS. Mr. Speaker, I yield 2 minutes to the gentleman from
Virginia (Mr. Cantor).
Mr. CANTOR. Mr. Speaker, I thank the gentleman for yielding me this
time.
Mr. Speaker, I rise in strong support of the Organ Donation
Improvement Act introduced by the gentleman from Florida (Mr.
Bilirakis) and the gentleman from Wisconsin (Mr. Barrett). This
legislation directs the Secretary of Health and Human Services to
conduct a public awareness campaign about the need for additional
organs for transplantation.
I am privileged to represent the hard-working men and women of the
United Network for Organ Sharing, UNOS, in Richmond, Virginia. Their
recent corporate campaign to increase organ donation complemented the
goal of this legislation, and that is why I want to publicly salute the
employees of UNOS and the families and friends of those who have
donated the ``gift of life,'' donated organs.
According to UNOS, for every patient who receives the organ he or she
needs, two more people in need of organs are added to the national
waiting list. Unfortunately, less than half of those who register on
the waiting list will ever receive a transplant. On average, 15 people
die every day because the organ they need does not come in time.
In 1999, more than 6,000 people died while awaiting organs. The same
year, the waiting list reached a high of more than 67,000 people. UNOS
works to address this life-and-death challenge by increasing organ
donation and making the most of every organ that is donated. This is
accomplished through organ matching and distribution, data research,
policymaking, education and public awareness.
Recently, several major employees in the metro Richmond area launched
employee campaigns to raise awareness about organ donation and increase
the number of organ donors in Virginia. The people of Virginia owe
these companies and their employees a debt of gratitude for their
efforts to promote a gift of life. I want to thank them for their hard
work, and I urge passage of this legislation.
Mr. Speaker, I include for the Record the UNOS press release of March
3, 2001.
[From the United Network for Organ Sharing, Mar. 3, 2001]
Richmond Employers Join UNOS To Increase Organ Donation
Richmond.--Several major employers in the metro Richmond
area have joined the United Network for Organ Sharing's
(UNOS) Workforce 2001, a unique effort to increase organ
donation.
BB & T; Back in Action Health Resource Center, Bank of
America, CapTech Ventures, Chesterfield County, City of
Richmond, The C.F. Sauer Company, Continental Societies,
Inc., Dominion Virginia Power, Durrill and Associates, First
Union, James River Technical, McCandlish and Kaine, M.H. West
and Co., Medical Insurers of Virginia; Owens and Minor,
Pleasants Hardware, PriceWaterhouseCoopers, SMBW Architects,
Style Weekly, SunTrust Bank, Tom Brown Hardware, Trigon Blue
Cross Blue Shield, Ukrop's Supermarkets and First Market
Bank, Verizon, Virginia Commonwealth University/Medical
College of Virginia, The Virginia Home; Wella Manufacturing
of Virginia; Westminster Canterbury; and Williams, Mullen,
Clark and Dobbins have committed to educating their employees
about the vital need for organ donation.
``Corporate involvement on the local and national level is
key to spreading the life-saving message of organ donation,''
said Walter K. Graham, UNOS executive director. ``We need
everyone's help to make sure the public has the right
information to make an informed decision about organ
donation.''
Nearly 700 people are currently awaiting an organ
transplant in Richmond, with approximately 2,000 waiting
statewide. There were 37 organ donors in Richmond during
2000, leading to more than 200 transplants.
Nationwide, 75,000 children, men, and women are registered
on the nation's organ transplant waiting list. To date, UNOS
reports that slightly more than 22,000 transplants were
performed in 2000 using organs
[[Page H675]]
from 5,900 cadaveric donors and 4,800 living donors.
For the year 2001, we project only moderate increases in
donation and transplantation, so of these 75,000 less than
one third will receive life-saving transplants this year. The
other two-thirds will continue to wait, and perhaps die
because the organ they need will not come in time to save
them. UNOS, and the employers of Virginia, are working
together to change this.
``A lot of people die in the U.S. and in Virginia because
they don't get the organs they need so desperately. If we
encourage everyone, starting with our own employees, to
become donors we can help the situation tremendously,'' said
Lynn Williamson, M.D., vice president and chief medical
officer for Trigon Blue Cross Blue Shield.
One of the main ways the organizations will communicate
with their employees about organ donation is a new electronic
public service announcement (PSA) that can be sent via e-mail
or posted on organization's Intranet site. The electronic PSA
highlights the importance of organ donation and gives the
viewer concrete steps they can take to be an organ donor.
Other ways employers are spreading the message include using
posters, brochures and paycheck stuffers.
Companies interested in joining the organ donation campaign
should contact UNOS at (804) 330-8563.
UNOS, a nonprofit charitable organization headquartered in
Richmond, VA, maintains the nation's organ transplant waiting
list under contract with the Health Resources and Services
Administration of the U.S. Department of Health and Human
Services. UNOS also promotes organ donor awareness in the
general public and the medical community.
Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentleman
from Rhode Island (Mr. Kennedy).
Mr. KENNEDY of Rhode Island. Mr. Speaker, I want to thank the
gentleman from Ohio (Mr. Brown) and the gentleman from Florida (Mr.
Bilirakis) for their work on this legislation. It is an important piece
of legislation.
I think anyone listening to this debate today, though there is not
much of a debate other than we need to do more in the way of giving
organs to people who need them, everyone should recognize the need to
sign up. First things first: everyone should sign up as an organ donor
right now or make a note to themselves to go up and sign up.
This is an easy thing to let pass: Oh yeah, I'm going to do it. I'm
going to do it. If it were not for one of our own colleagues, the
gentleman from Massachusetts (Mr. Moakley), I would not have signed up.
I recall when the gentleman from Massachusetts got this organs donation
caucus together. We have several colleagues on both sides of the aisle
who are beneficiaries of organ donations. There is nothing like hearing
a story from someone who has benefited from an organ donation to make
someone a believer and feel that they ought to sign up themselves.
So I encourage everyone to do it. Most people can go down to the
registry of motor vehicles in most States, as in my State of Rhode
Island. A form is signed which makes an individual an organ donor, puts
them on the list, and makes sure the individual's license reflects it.
So in a time when we are no longer on this earth but our organs are, we
can help someone else to live. I think that is the kind of thing we
would all want to have made possible.
So I hope we all support this organ donation legislation. In my
State, there were 71 organs donated last year, although there are
36,000 still on the waiting list in my State of Rhode Island. We have a
tragic shortage of organs and we need to pass this legislation, H.R.
624, so that we can help expand awareness of this important process of
donating an organ.
I encourage everyone to find someone that has benefited from this or
log on and learn more about it, because I believe if people learn more
about it they will become organ donors. It is an absolute tragedy that
more Americans of good conscience and good will just are not because
they have not gotten around to doing it. So anyone listening to this,
please make sure to sign up to be an organ donor.
{time} 1315
Mr. BILIRAKIS. Madam Speaker, I yield myself 1 minute.
Madam Speaker, just one parliamentary note. The committee filed its
report on H.R. 624 last night. That report contained, as required under
the House rules, a cost estimate for the bill from the Congressional
Budget Office. However, H.R. 624, as introduced, contained a drafting
error. An amendment to the basic legislation today took care of that.
As a result, CBO provided its cost estimates on the amendment, on the
bill, as amended, to H.R. 624 that we are considering today. I hope
that this clears up any confusion.
In closing, Madam Speaker, I would like to acknowledge people who
have really worked on this not only for this particular piece of
legislation but even in the prior years, the staffs from the committee,
Marc Wheat, Brent DelMonte; John Ford, who is here; Katie Porter from
the minority; Erin Ockunzzi, a member of my personal staff; my chief of
staff Todd Tuten. We are all very grateful to those good people for the
hard work that they have placed on this legislation.
Mr. DINGELL. Madam Speaker. According to the most recent annual
report of the United Network for Organ Sharing (UNOS), the shortage of
organs for transplant is getting worse. Approximately 21,715
transplants were performed in 1999. The number of persons on the
national transplant waiting list as of February 2001 was approximately
74,000. The number of deaths among persons who were on the transplant
waiting list tripled in the decade of the 1990s. Although cadaveric and
live donation rates have increased, the need for these organs has grown
even faster.
I applaud the effort of my colleagues to raise awareness of the need
for more organ donations. I want to also pledge to work with Secretary
Thompson on this important issue. He has indicated that he will make
organ donation a priority of this administration. One interesting
statistic he often cities is that two-thirds of Americans have not
expressed their wishes about donation.
Clearly, there is much that can be done to increase organ donations.
The two measures before us today, H. Con. Res. 31 and H.R. 624, are
steps in the right direction. I want to make particular note of the
efforts of my friend and colleague, Representative Karen Thurman. She
has made all of us aware of the need to act quickly and decisively to
address a host of donation issues. Her resolution on organ, tissue,
bone marrow, and blood donation deserves our enthusiastic support.
H.R. 624 addresses both cadaveric and living donations. There are
obvious limitations with respect to live donations, so we must attack
the shortage on both fronts, cadaveric and live donations. Ninety-five
percent of live donations are kidneys, with the remaining five percent
involving the split liver technique. Cadaveric donations thus make up
part of the supply of transplantable kidneys and livers, and the entire
supply of hearts, pancreas, lungs, and intestines.
H.R. 624 is an incremental step. It is not a comprehensive program. I
hope this is merely a reflection of the process by which this bill
comes before us today and does not reflect a limitation on our
collective will to make lasting and meaningful progress toward
increasing the supply of organs. There are many good ideas we should
examine and I hope that in due course, we will.
Finally, I remain wary of the bill's residency and ``covered
vicinity'' provisions. I will be monitoring the implementation of H.R.
624 to be sure it does not stray from its intended purpose.
With that Madam Speaker, I urge my colleagues to support these two
measures.
Mr. UNDERWOOD. Madam Speaker, I support today H.R. 624, the Organ
Donation Improvement Act of 2001, introduced by my colleague,
Congressman Bilirakis of Florida.
This bill will support payment of travel and subsistence expenses
incurred by individuals making living donations of their organs, raise
public awareness of the importance of organ and tissue donation in our
country, and help families understand and respect the wishes of family
members who desire to be individual organ donors.
Although organ and tissue transplantation is not a common procedure
in my district of Guam as it is in larger metropolitan areas of the
country, the need is still great as heart disease and diabetes are
among the leading causes of death on the island. In fact, heart disease
ranks as the number one killer, while diabetes ranks very close to the
top and affects Chamorros at 5 times the national average.
The impact of higher costs and greater distances between Guam and the
nearest major metropolitan hospital in Honolulu, approximately 3,500
miles or 7 hours by plane, is a vital concern when it comes to health
care for U.S. citizens on Guam. Some of Guam's patients are medically
evacuated to larger metropolitan health care centers in Honolulu and
Los Angeles for these procedures. Other times, the organ and tissue
donations are transported to Guam for transplantation. So, the access
to organ and tissue donation is a critical component of whether a
patient lives or dies.
Since the majority of those who are medically evacuated to hospitals
in Honolulu and in
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the continental United States are Medicare and Medicaid patients, the
cost of travel and subsistence payments for individual living donors is
a welcome relief to those who are able to find a perfect organ donor
match.
The program to raise public understanding and assist states and
territories in carrying out organ donor awareness, public education,
and outreach activities is also a welcome component of the Organ
Donation Improvement Act. For minority communities, such as the Asian
Pacific American community, this is a particularly welcome initiative.
Mr. TOM DAVIS of Virginia. Madam Speaker, I rise in strong support
today for H.R. 624, the Organ Donation Improvement Act. I have seen
first-hand how important organ donation can be. My own sister-in-law
has been the recipient of a transplanted kidney. Unfortunately, not
every person who needs an organ transplant is as lucky as she was. In
1999 alone, over 6,000 people died while on the waiting list for a
donor organ.
Despite continuing advances in medicine and technology, the tragic
truth is that the demand for organs drastically outstrips the supply of
organ donors. According to a recent report, the number of Americans
waiting for organ transplants more than tripled from 21,914 to 72,110
between 1990 and the end of 1999. However, annual donor transplants
over the same period increased at a far slower rate, going from 15,009
in 1990 to 21,715 in 1999.
H.R. 624 is an important step in addressing this crisis. This bill
directs the Secretary of Health and Human Services to carry out a
program to educate the public with respect to organ donation. It also
authorizes grants to cover the costs of travel and subsistence expenses
for individuals who make living donations of their organs.
I believe that it is of the utmost importance that we encourage more
individuals to share the life-saving benefits of organ donation.
Therefore, I urge my colleagues to give this bill their full support.
Mr. RUSH. Madam Speaker, I rise in support of the Organ Donation
Improvement Act of 2001, H.R. 624, which was reported by the Energy and
Commerce Committee last week. As reported, H.R. 624 authorizes up to $5
million each year--for each of the next five years--to provide travel
and subsistance funds for organ donors meeting certain criteria.
I support the bill because I have been assured by the distinguished
chairman of the Health Subcommittee, my friend Mike Bilirakis that the
bill is intended to help increase the supply of life-saving organs that
are available nationwide, and that it is not an attempt to circumvent,
abrogate, amend or revise the organ donation and allocation system
which was implemented by the Department of Health and Human Services
last year.
Under the provisions of the National Organ Transplant Act (NOTA), the
U.S. Department of Health and Human Services has the responsibility for
establishing and administering a national organ allocation program. In
April of 1998, the Department published a regulation which directs the
Organ Procurement and Transplantation Network (OPTN) to address a
number of inefficiencies and inequities in the existing organ
allocation program. UNOS, the United Network for Organ Sharing, and a
number of transplant centers, strongly objected to the regulation. The
groups in opposition sought and secured a rider to the Omnibus
Appropriations enacted in 1998 which blocked implementation of the
Secretary's proposed regulation.
In October, 1998, the Congress suspended implementation of the Final
Rule for one year to allow further study of its potential impact.
During that time, Congress asked the Institute of Medicine (IOM) to
review current Organ Procurement Transplantation Network (OPTN)
policies and the potential impact of the Final Rule. The IOM study was
completed in July, 1999 and provided overwhelming evidence in favor of
the new regulations. Nevertheless, a second moratorium was added onto
the Work Incentives Improvement Act, that provided for an additional
90-day delay on implementation of the Final Rule.
In the midst of this debate, in October, 1999, the House Commerce
Committee debated and reported legislation, H.R. 2418, that would have
divested the Department of Health and Human Services of any authority
to require anything of the OPTN. Functions of a scientific, clinical or
medical nature would be in the sole discretion of the OPTN. All
administrative and procedural functions would require mutual agreement
of the Secretary and the Network.
Opponents of H.R. 2418, including the Governor of the great state of
Illinois, believed that the legislation would create an unregulated
monopoly of organ allocations, and allow UNOS to run the organ
allocation program unfettered. The legislation would also have favored
small states with small centers at the expense of patients waiting for
transplants at larger centers. The state of Illinois represents 9
percent of the population and receives only 4 percent of the
transplants.
While debate on H.R. 2418 raged in the House, during 1999 and 2000,
the U.S. Department of Health and Human Services (HHS) made several
attempts to implement a new organ donation and allocation regulation.
The HHS regulation incorporates many of the sound recommendations of
the National Academy of Sciences' Institute of Medicines
recommendations for improving the organ donation and allocation system.
This regulation--the subject of opposition by those groups which would
have maintained the status quo--had twice been delayed by Congressional
action, but finally went into effect in March, 2000.
Madam Speaker, in January of this year, former Health and Human
Services Department Secretary, Donna E. Shalala, announced the
appointment of 20 members to the Secretary's new Advisory Committee on
Organ Transplantation. The committee, which was created in the Organ
Procurement and Transplantation Network rule of 1999 and recommended by
the Institute of Medicine Report to Congress in 1998, will advise the
Secretary on all aspects of organ procurement, allocation and
transplantation. The new Department of Health and Human Services
Secretary, the Honorable Tommy Thompson, has said that improvements to
the organ donation and allocation system are one of his major
priorities.
Madam Speaker, it is my hope that, in the future, as this House and
the Energy and Commerce Committee continues its oversight on the
administration of the organ donation and allocation system, that we not
rush to judgment--as we did with this legislation--with no hearings, no
consultation, and no oversight by the committees of jurisdiction and
the Members of this House that are so vitally interested in this issue.
Mr. STARK. Madam Speaker, I rise in support of H.R. 624, the Organ
Donation Improvement Act.
H.R. 624 is an important piece of legislation that provides financial
assistance to living donors to cover the travel expenses associated
with donating an organ, and provides new funds for programs to educate
the public with respect to organ donation.
In a National Kidney Foundation Survey, one out of four family
members said that financial considerations prevented them from
volunteering to become a living donor. When you consider airfare,
hotel, ground transportation, and food for a few days, the costs add
up. This bill would provide grants to states, transplant centers, organ
procurement organizations, and other public entities to enable them to
pay for the non-medical travel and subsistence expenses incurred by a
donor in conjunction with organ donation. It is targeted to recipients
with incomes below $35,000 a year who might not otherwise be able to
aide a donor in paying for travel costs.
More people would be able to become living donors if we remove this
cost barrier. In a country as wealthy as ours, we cannot allow those
who are in need of an organ to miss a life-saving opportunity because
of a lack of travel funds for a family member or other matching donor.
Moreover, we must facilitate more people becoming living organ donors
by removing whatever obstacles we can.
This bill would also authorize the Secretary of Health and Human
Services to make grants to states or contract with organizations to
educate the public on organ donation. States that receive grants would
be required to submit annual reports to the Secretary assessing the
effectiveness of the programs, so that successful programs can be
replicated in other states. We need to get as many people as possible
to fill out organ and tissue pledge cards, and enter their information
in the National Marrow Donor Program Registry through education
campaigns. The Federal government needs to work with States, and non-
profit organizations to reach every person in this country. Any of us
could one day need a transplant.
This bill takes a step in the right direction, but it should be
considered a piece in a broader effort to increase organ donation in
this country. Every 14 minutes a new name is added to the transplant
waiting list. We need to insure that every 14 minutes a new donor signs
a pledge card. We have far to go before we've reached that goal, but
this bill moves us closer.
Secretary Thompson has already indicated that he plans to launch a
national awareness campaign and to do more to recognize donors and
their families. This would be a great opportunity for Congress to
collaborate with him to draw attention to this life-saving issue. I
urge my colleagues to vote in support of this important legislation to
increase organ donations.
Mr. VITTER. Madam Speaker, I rise today to express my support for
organ donation and the sentiment in H.R. 624 to emphasize the
importance discussing organ and tissue donation as a family. I'm proud
to say that in my home state of Louisiana, the LSU Health Sciences
Center, working with Legacy Donor Foundation and the Louisiana Organ
Procurement Agency, developed a model campaign
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now used by businesses that is very successful in getting employees to
sign up to become organ donors at death. Despite these advances, in
Louisiana and across our nation, a lot more public education is needed
to raise awareness of the critical shortage of organs. In addition,
Louisiana has also benefited from the services provided by the Oschner
Multi-Organ Transplant Center, where over 50 liver transplants are
performed each year. The help these organizations provide to patients
in Louisiana are immeasurable.
For example, in Louisiana today there are about 1,600 individuals--
mothers, fathers, husbands, wives, sons, daughters--awaiting a life-
saving transplant. Nationally, more than 73,000 men, women and children
awake in hope each day that it will be the day when they receive their
new organ, before it's too late for them. But needs far exceed organ
donations each year. One organ donor can save the lives of as many as
eight others. Organs from 100 individuals in Louisiana were donated
last year, providing 365 organs for transplant. Those 100 selfless
humans in Louisiana gave the gift of life to strangers as their legacy.
Organ donation is the last act of selfless generosity that one human
being can perform for another.
Mr. CUMMINGS. Madam Speaker, I rise today in support of H. Con. Res.
31 and H.R. 624, both expressing Congress' acknowledgment of the need
for organ donors and organ donor support for all citizens.
In 1996, I introduced H.R. 457 (Public Law No. 106-56), the Organ
Donor Leave Act, because I am a firm believer in the life-saving power
of organ donation. This legislation allows federal employees up to 30
days paid leave after having made an organ donation and 7 days for
those employees making a bone marrow donation. Through we have made
progress in the fight for increasing the support for organ donors, it
is out of that same unshaken belief that I recognize the need for
legislation like H. Con. Res. 31 and H.R. 624. I know the truth and the
truth is that there is still much than can be improved.
Over 60,000 Americans are awaiting for an organ donation, while 12
people die each day waiting for a transplant.
Every sixteen minutes, a new name in need of an organ, tissue, or
bone marrow transplant is added to a waiting list.
Each year, despite the efforts of countless Americans who are organ
donors, over 4,000 Americans die in need of a transplant.
These grim statistics are the real reason why I stand behind H.R.
624, the Organ Donation Improvement Act of 2001, which will not only
foster increased public awareness through studies and demonstrations,
but also supports organ donors through financial assistance incurred
toward living organ donation. Furthermore, as H. Con. Res. 31 states, I
fully support National Donor Day which promotes awareness and while
educating ALL about organ, tissue, bone marrow, and blood donation.
In both of these bills, we move another step forward in helping to
eliminate a solvable problem, paving the way toward answering the hopes
and needs of those who now wait too long for a second chance at life.
Mr. KIND. Madam Speaker, today, I rise in support of H.R. 624, the
Organ Donation Improvement Act. As we all know, there is a shortage of
organ donors across the United States. In fact, the waiting list for
organ transplants has grown by over 300 percent in the last decade.
I am, however, proud that my state of Wisconsin has an excellent
record in organ procurement. Wisconsin's two organ donation agencies,
the Wisconsin Donor Network in Milwaukee and the University of
Wisconsin Organ Procurement organization, are nationally recognized for
their donation rates. Each year in Wisconsin, nearly 150 people give
more than 600 citizens the opportunity for a new beginning.
In order to decrease the number of individuals on the wait list for
organ transplants, we need to increase people's willingness to become
donors. Wisconsin has a model intensive education program that works
closely with schools, community groups, church groups and the hospitals
to allay individuals' questions and concerns related to organ donation.
I am proud to be a cosponsor of the Organ Donation Improvement Act that
would provide grants to states to build programs similar to our
successful program in Wisconsin.
This bill recognizes the critical role that states can play in
improving organ donation. I urge my colleagues to support this
important legislation.
Mr. BENTSEN. Madam Speaker, I rise in strong support of the Organ
Donation Improvement Act (H.R. 624), legislation that will help the
60,000 people in the United States who are currently waiting for organ
transplant surgery. This year, approximately 20,000 people will receive
these lifesaving operations, but 40,000 people will not. This
legislation is an important first step in helping these patients and
their families to get the organs that they desperately need.
As the representative for the Texas Medical Center where many of
these transplantations occur, I am concerned about the need to find
more organs for these patients. Many of these lifesaving procedures are
conducted at the transplant departments at these teaching hospitals in
my district. During the past decade, the waiting list for organs has
grown by more than 300 percent. Clearly, we are not finding sufficient
donors to meet the demand for these patients.
As an original cosponsor of this legislation, I strongly support this
effort to increase organ donations. First, this measure authorizes $5
million for each of the next five years to help pay for the cost of
travel and subsistence expenses for people who donate their organs.
With advanced technology and techniques, today there are more
opportunities for people to donate organs. However, many patients
cannot afford to travel and pay for the costs associated with organ
donation surgeries. This bill would encourage more patients to donate
an organ if they know that both their travel and subsidence expenses
will be covered. These grants would be given to only those low-income
patients who cannot afford to travel to another state in order to
donate an organ. In addition, these grants can help donors to receive
supplemental income during the time period when they are donating an
organ.
This bill would also require the Secretary of Health and Human
Services (HHS) to conduct a public awareness program on organ donation.
With more awareness, it is my hope that more families will discuss
organ donation and will give the ``gift of life'' to another patient.
This measure also includes a provision to authorize grants for studies
and pilot projects to increase organ donations to private
organizations.
I am also pleased that the American Hospital Association and the
Patient Access to Transplantation Coalition have expressed their strong
support for this bill. I urge my colleagues to vote for this
legislation.
Mr. BILIRAKIS. Madam Speaker, I yield back the balance of my time.
Mr. BROWN of Ohio. Madam Speaker, I yield back the balance of my
time.
The SPEAKER pro tempore (Mrs. Biggert). The question is on the motion
offered by the gentleman from Florida (Mr. Bilirakis) that the House
suspend the rules and pass the bill, H.R. 624, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of
those present have voted in the affirmative.
Mr. BILIRAKIS. Madam Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.
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