[Congressional Record Volume 149, Number 40 (Wednesday, March 12, 2003)]
[House]
[Pages H1763-H1766]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
ORGAN DONATION IMPROVEMENT ACT OF 2003
Mr. TAUZIN. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 399) to amend the Public Health Service Act to promote organ
donation.
The Clerk read as follows:
H.R. 399
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 Improvement
Act of 2003''.
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
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(as adjusted for fiscal year 2004 and subsequent fiscal years
to offset the effects of inflation occurring after the
beginning of fiscal year 2003).
``(2) Certain circumstances.--Subject to paragraph (1), the
Secretary may in carrying out subsection (a) provide as
follows:
``(A) The Secretary may consider the term `donating
individuals' as including individuals who in good faith incur
qualifying expenses 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 2004
through 2008.''.
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, tissue banks, eye banks, and other States upon
a search request; and
``(4) report to the Secretary on an annual basis a
description and assessment of the State's use of these grant
funds, accompanied by an assessment of initiatives for
potential replication in other States.
Funds may be used by the State or in partnership with other
public agencies or private sector institutions for education
and awareness efforts, information dissemination, activities
pertaining to the State 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 2004, and such sums as may be necessary for
each of the fiscal years 2005 through 2008. Such
authorization of appropriations is in addition to any other
authorizations of appropriations that are 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
Louisiana (Mr. Tauzin) and the gentleman from Louisiana (Mr. John) each
will control 20 minutes.
The Chair recognizes the gentleman from Louisiana (Mr. Tauzin).
General Leave
Mr. TAUZIN. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days within which to revise and extend their remarks
and to insert extraneous material on H.R. 399, the bill under
consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Louisiana?
There was no objection.
Mr. TAUZIN. Mr. Speaker, I yield such time as he may consume to the
gentleman from the great State of Florida (Mr. Bilirakis), the chairman
of the Subcommittee on Health, that produced this important
legislation.
Mr. BILIRAKIS. Mr. Speaker, I appreciate the gentleman's yielding me
this time, and I rise in strong support of H.R. 399, the Organ Donation
Improvement Act of 2003. This bipartisan bill was unanimously approved
by the Committee on Energy and Commerce in February, and I urge all of
my colleagues to join me in supporting this timely legislation.
Mr. Speaker, we are all aware of the great need for donated organs
and tissue. According to the United Network for Organ Sharing, there
are 80,791 people currently waiting for a transplant. Sadly, only
18,693 individuals had received a transplant as of September 2002, and
more than 4,500 Americans died, died while on the waiting list.
Fortunately, Mr. Speaker, there is hope. Living donors represent a
growing segment of the total organ donation pool. In fact, living
donors represented over half of all donors in the first 9 months of
2002. That is why H.R. 399 authorizes the Secretary of Health and Human
Services to award grants for the purpose of covering travel and
subsistence expenses incurred by living organ donors. While the
decision to become a living organ donor is an intensely personal one, I
feel that it is our responsibility to remove any financial barriers
that might prevent someone from making the gift of life.
H.R. 399 also provides the Secretary with $10 million in new grant
authority to assist State governments and public and nonprofit private
entities in developing innovative initiatives designed to increase
organ donation rates, including living donation. I am hopeful we will
learn some valuable lessons from these demonstration projects that we
will be able to apply on a national scale.
H.R. 399 is widely supported, Mr. Speaker, by the transplant
community. Organizations supporting my bill include the American
Society of Transplant Surgeons, the American Society of
Transplantation, the United Network for Organ Sharing, the Association
of Organ Procurement Organizations, the National Kidney Foundation, the
American Liver Foundation, the North American Transplant Coordinators
Organization, the Patient Access to Transplantation Coalition, and the
Eye Bank Association of America.
{time} 1300
Mr. Speaker, while I would never suggest that this bill encompasses
every meritorious idea to increase organ and tissue donation, it is a
very good bill and takes a positive step forward in our effort to
ensure that every American has access to a donated organ or tissue when
they need it.
Mr. JOHN. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in strong support of H.R. 399, the Organ Donation
Improvement Act of 2003. I thank the gentleman from Florida (Mr.
Bilirakis), along with the gentleman from Louisiana (Mr. Tauzin), the
gentleman
[[Page H1765]]
from Michigan (Mr. Dingell), and also the gentleman from Ohio (Mr.
Brown), the chairman of the Subcommittee on Health, for introducing the
legislation and working to encourage a more efficient and widespread
organ donation program and activities.
These numbers are staggering. Currently there are 78,000 men, women,
and children waiting as we speak today for a kidney, heart, liver, lung
or pancreas. Fewer than one-third of the 78,000, however, will receive
a transplant this year. An average of 15 people die every day, one
every 96 minutes, waiting for an organ that could have saved their
life.
Sadly, while most Americans indicate that they support organ
donation, only 50 percent of the families that are asked to donate an
organ do so. This is an important piece of legislation that will work
towards reducing the shortage of transplantable organs, tissues, eyes.
Grants will be used to assist States in carrying out organ donation
awareness, public education, outreach activities, and programs designed
to increase the number of organ donors within a State. This is a very
important, very good piece of legislation; and I enthusiastically
support H.R. 399.
Mr. Speaker, I reserve the balance of my time.
Mr. SHIMKUS. Mr. Speaker, I ask unanimous consent that I may be
permitted to control the time of the gentleman from Louisiana (Mr.
Tauzin).
The SPEAKER pro tempore (Mr. LaHood). Is there objection to the
request of the gentleman from Illinois?
There was no objection.
Mr. SHIMKUS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, Illinois and many other States have the ability to sign
the back of their driver's license to give the gift of life, which is
organ donation. That is in addition to the legislation that we have
here on the floor today. I am pleased that the House is considering
H.R. 399, the Organ Donation Improvement Act. This legislation builds
on existing Department of Health and Human Services programs and
encourages more Americans to give the gift of life.
Medical advances and the generosity of organ and tissue donors enable
more than 22,000 Americans per year to receive organ transplants that
save or enhance their lives. Despite their self-sacrifice and charity
of these donors, this is only a small proportion of the more than
76,000 Americans who are now on the waiting list hoping to prolong
their life by finding a matching donor.
Tragically, the number of patients waiting for organ transplants rose
more than five times as fast as the number of transplant operations in
the 1990s, according to an annual report by the United Network for
Organ Sharing. As a result, about 5,500 people die in the United States
each year, or 15 patients each day, while waiting for a donated heart,
liver, kidney or other organ. It is estimated that every 16 minutes a
new name is added to this growing waiting list.
As the demand for transplantation increases, the shortfall in organ
donors for those with end-stage organ disease or organ failure will
become even more pronounced. In order to narrow the gap between the
supply and the increasing demand for donated organs, there must be an
effort to encourage willing donors and create an environment conducive
to organ donation.
H.R. 399 accomplishes this objective by permitting the Secretary of
the Department of Health and Human Services to make grants to States,
transplant centers, qualified organ procurement organizations, or other
public or private entities for the purpose of providing for the payment
of travel and subsistence expenses incurred by individuals who are
making living donations of their organs.
In addition, the bill requests the Secretary to carry out studies and
demonstration projects for the purpose of educating the public with
respect to organ donation. These grants will assist the States in
carrying out organ donor awareness, public education, and outreach
activities, programs designed to increase the number of organ donors
within a State, including live donors.
Mr. Speaker, I thank the gentleman from Florida (Mr. Bilirakis) for
his dedication in moving forward with this legislation. There is no
greater gift than the gift of life. I also thank the gentleman from
Louisiana (Chairman Tauzin) and my colleagues on the other side of the
aisle who are very supportive of this legislation, and we were able to
bring this up expeditiously.
Mr. Speaker, I reserve the balance of my time.
Mr. JOHN. Mr. Speaker, I yield such time as he may consume to the
gentleman from Illinois (Mr. Davis).
(Mr. DAVIS of Illinois asked and was given permission to revise and
extend his remarks.)
Mr. DAVIS of Illinois. Mr. Speaker, I thank the gentleman from
Louisiana (Mr. John) for yielding me this time. I commend the gentleman
and all of the members of the subcommittee, and all of those who have
brought this matter to the floor.
Mr. Speaker, I rise today in support of H.R. 399 and the need to
continue awareness and education programs for organ donation. I was
very pleased recently to be part of the 6th Annual National Donor Day
at the Chicago Automobile Show on February 14 with the Illinois
Secretary of State, the Honorable Jesse White, and Connie Payton, the
widow of football legend Walter Payton. This is the single largest 1-
day blood, organ and tissue donation drive in America.
However, we know that the drive and awareness brought to this great
need should occur and is needed to occur more than just 1 day during
the year. I am proud to represent five of the six world-class hospitals
in Chicago that are part of the National Marrow Donor Program's network
of transplant centers, including Northwestern Memorial Hospital, Rush-
Presbyterian, Children's Memorial, the University of Illinois at
Chicago, and Loyola Medical Center. These hospitals play a major role
in not only making the public aware of the great need of donation but
carrying out safe organ transplant procedures.
This need is particularly present in the African American population
where African Americans make up less than 10 percent of the 4.8 million
donors on the registry. On any given day, more than 80,000 Americans
are waiting for an organ transplant. That number continues to rise by a
new name every 14 minutes. Each day, 63 people receive an organ
transplant, but 16 people will die because an organ is not donated.
Fifty percent of those waiting for an organ transplant are minorities.
Almost a full third of those waiting for an organ transplant in the
United States are African Americans; 35 percent of those waiting for a
kidney transplant are African American.
Some diseases of the kidney, heart, lung, pancreas, and liver are
found more frequently in racial and ethnic minority populations than in
the general population. For example, African Americans, Asians, Pacific
Islanders, and Hispanics are three times more likely to suffer from
kidney failure than whites. Native Americans are four times more likely
than whites to suffer from diabetes.
Some of these diseases are best treated through transplantation, and
others can only be treated through transplantation.
This legislation will allow States to receive grants to assist in
organ donor awareness, public education and outreach activities, and
programs designed to increase the number of organ donors within States,
including living donors. It will assist in getting the word out that if
one person does the simple task of signing a donor's card, 50 people
will be able to receive an organ donation and begin a new, healthy
chapter in their life.
Mr. Speaker, again, I am pleased to support this legislation, commend
all of those who had a hand in bringing it to the floor, and urge its
passage.
Mrs. WILSON of New Mexico. Mr. Speaker, Kyle is a normal second
grader in New Mexico. But, when he was just nine days old, he and his
family traveled to Loma Linda California for a much needed heart
transplant. Every year, they make that same pilgrimage to Loma Linda
for evaluations. It is 747 miles from Albuquerque to Loma Linda.
The current regional transplant model with a national, government-run
program results in fewer organs available to New Mexicans. While organs
are shared over wide geographical areas, donated organs are sent out of
state. I think this system has caused fewer New Mexicans to donate
organs, and it has certainly impeded the decision of families to pursue
a transplant.
[[Page H1766]]
I applaud provisions of this bill which seek to educate the public on
organ donation. It is by reaching folks one by one that awareness is
raised. In New Mexico much of the public has misconceptions about this
important issue. Since we have lost our transplant programs, many
individuals decide that the travel distance, time, separation from
family, and logistics are just too hampering. It is just too
complicated and too much of a burden. We have some of the highest rates
of Diabetes, Kidney disease, and Hepatitis B and C of any state, and
yet our rates of transplants are among the lowest. We need hearts, we
need livers, we need pancreases, and we need the ones we procure to
stay close to home.
I also reiterate support for the sense of Congress contained in his
bill that refers to family discussions of donation. Encouraging such
dialogues to take place will help make decisions early. There are 32
states in which being designated an organ donor on a driver's license
carries no legal weight at all. It is by communicating an individual's
desires with family members that counts. Oftentimes, it is a point of
crisis in which a family must make a decision whether or not to donate
a loved ones' organs. If this is talked about beforehand, the desires
of each family member can be made known. It is families that are
affected by organ donation, and families that should make the
decisions.
Mr. STARK. Mr. Speaker, I rise in support of the Organ Donation
Improvement Act of 2003, H.R. 399. The commendable purpose of this bill
is to increase public awareness of the need for organ donation and
institute procedures to increase the frequency of this brave and noble
act.
There is a serious shortage of available organs for donation. There
are currently over 80,000 people waiting for an organ transplant and a
new name is added to the waiting list every 13 minutes. As a result of
the low rate of organ donation in this country, more than 6,000 people
died in 2001 for lack of an available suitable organ. The passage of
this bill and the implementation of its provisions will help to
markedly reduce the number of such deaths in the future.
I commend Representative Michael Bilirakis for introducing this bill
and taking interest in this vital area. I encourage my colleagues to
support this life saving legislation.
Mr. UPTON. Mr. Speaker, I rise in support of H.R. 399, the Organ
Donation Improvement Act of 2003, of which I am a cosponsor. Let me
just mention one number, that for me, says it all about why we need
incentives to increase organ donations across the nation. In Michigan,
over an 11-month period ending on December 1 of last year, 2,420
individuals were waiting for organs, and 164 people had died while
waiting. These are our constituents, our families, our friends. I know
the Transplant Society of Michigan, our state's organ procurement
organization, is working hard to increase donations. But they could use
a helping hand, as could OPOs across the nation. The Organ Donation
Improvement Act we are marking up today is a very good start.
As of September 2002, the organ transplant waiting list had more than
80,000 men, women, and children waiting for a new kidney, heart, liver,
lung, pancreas, or intestine. Unfortunately, an average of 17 people
die every day, one every 85 minutes, waiting for an organ that could
have saved their lives. H.R. 399 takes aim at increasing anatomical
giving to help meet the critical need for vital human organs and give
hope for life for those that have no other options for treatment or
cure.
The key to donation is public education and awareness. This
legislation gives the Secretary of Health and Human Services the
ability to award grants to States for the purpose of assisting States
in carrying out organ donor awareness, public education and outreach
activities designed to increase the number of organ donors. While there
is a desperate need for vital human organs, the American public should
know that there is also a continuing need for donated human eyes and
tissue. Donation is the term used to describe the humanitarian act of
giving to help another. Anatomical gifts include vital, life-saving
human organs, sight restoring eyes, and repair and reconstruction human
tissue such as bone, cartilage, tendons, skin, and heart valves.
At national, state, and local levels, a partnership exists between
the organ, eye and tissue bank communities. While all three communities
are considered separate, given differences in medical criteria,
training needs and distribution pathways, they are united in their
message to encourage the act of donation. Organ donation saves lives,
eye donation restores sight, and tissue donation provides skin grafts
for critically injured burn patients and benefits thousands of patients
in need of bone, cartilage, tendons, and heart valves. Without a donor,
transplant surgeons cannot save and improve the health of even one
individual.
Every individual can sign-up to be a donor, regardless of health or
medical condition. It is imperative, however, that individuals openly
discuss their decision to donate with family and friends so that they
may help honor their loved one's wishes and are knowledgeable about
their options. Just one individual can save and improve as many as 50
lives. Representatives of hospitals, organ banks, eye banks, and tissue
banks work hand in hand to see that loved ones' wishes are respected
and that gifts are properly handled for the benefit of others. I
commend these organizations for working tirelessly toward this end and
for their efforts to educate the public on the benefits of donation.
In closing, I fully encourage all Americans to consider the
altruistic act of donation and to make others aware of your decision.
Ms. BORDALLO. Mr. Speaker, today, I join my colleagues in support of
H.R. 399 to amend the Public Health Service Act to promote organ
donation. I want to thank Congressman Bilirakis for his commitment to
this cause.
The advances in technology have increased the chances of survival for
many suffering from life-threatening illnesses. But technology alone is
not enough. In many cases, survival depends on some form of transplant.
Sadly, the need far exceeds the number of donors. H.R. 399 is a big
step in addressing this serious demand.
Educating the public about the need for donors and the ways one can
become a donor is crucial. Many believe that donation only comes at the
end of a life. But each year thousands get a new change at life through
the generosity and courage of living donors. For the families facing
the loss of a loved one, donation is a legacy of life and an example of
the best of humanity in the face of tragedy.
In promoting awareness of the need for donors, H.R. 399 offers hope
to thousands waiting for another chance at life. I strongly support
H.R. 399 and urge its passage.
Mr. JOHN. Mr. Speaker, I have no further requests for time, and I
yield back the balance of my time.
Mr. SHIMKUS. Mr. Speaker, I have no further requests for time, and I
yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Louisiana (Mr. Tauzin) that the House suspend the rules
and pass the bill, H.R. 399.
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. SHIMKUS. Mr. 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.
____________________