[Congressional Record (Bound Edition), Volume 146 (2000), Part 2]
[Extensions of Remarks]
[Page 2679]
[From the U.S. Government Publishing Office, www.gpo.gov]



          ORGAN DONATION AND TRANSPLANTATION IMPROVEMENTS ACT

                                 ______
                                 

                           HON. BOBBY L. RUSH

                              of illinois

                    in the house of representatives

                        Thursday, March 9, 2000

  Mr. RUSH. Mr. Speaker, today, I am pleased to join with my colleague, 
Ray LaHood, in introducing the Organ Donation and Transplantation 
Improvements Act of 2000, a bill to amend the Public Health Service Act 
to improve the national system of organ allocation and transplantation.
  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 of last year and provided overwhelming evidence in 
favor of the new regulations. Nevertheless, at the end of the last 
session of Congress, a second moratorium was added onto the Work 
Incentives Improvement Act, that provided for an additional 90-day 
delay of implementation of the Final Rule.
  In the midst of this debate, last October, the House Commerce 
Committee debated and reported legislation, H.R. 2418, that would 
divest 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, believe that the legislation would create an unregulated 
monopoly of organ allocations, and allow UNOS to run the organ 
allocation program unfettered. The legislation also favors 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.
  The legislation which Mr. LaHood and I are introducing today takes 
elements from a variety of different sources and combines them into a 
comprehensive bill aimed at improving the performance of the nation's 
organ donation and transplant system. The bill includes elements from:
  The existing National Organ Transplant Act (NOTA);
  H.R. 2418, the Organ Procurement and Transplantation Network (OPTN) 
Amendments of 1999;
  The OPTN regulation promulgated by the Department of Health and Human 
Services and revised in 1999; and
  Recommendations from the Institute of Medicine in its 1999 report: 
Organ Procurement and Transplantation.
  The goal of the Donation and Transplantation Act is to increase organ 
donation rates and to foster a fair and effective system for improving 
the nation's organ transplantation system.
  The legislation that we are introducing supports a number of programs 
aimed at increasing organ donation by establishing a grant program to 
assist organ procurement organizations (OPO) and other non-profit 
organizations in developing and expanding programs aimed at increasing 
organ donation rates; creating a Congressional Donor Medal to be 
awarded to living organ donors or to organ donor families; establishing 
a system of accountability and places the responsibility for increasing 
organ donation with the Department of Health and Human Services (HHS 
must report its progress to Congress); and establishes a system of 
support for state programs to increase organ donation.
  Congress created the Organ Procurement and Transplantation Network 
(OPTN) in 1984 to create a fair and effective system for matching organ 
donors with patients in need of organ transplants. The Act maintains 
the high medical standards established by Congress in 1984; further 
defines the organ allocation standards established by Congress in 1984 
in order to ensure a fair and equitable system of allocation based upon 
the recent recommendations of the Institute of Medicine; establishes 
new standards of financial accountability in the operation of the OPTN; 
and requires the Department of Health and Human Services to work with 
the OPTN contractor to monitor and enforce the policies of the OPTN.
  The Act further removes the burden for organ allocation from the 
Organ Procurement Organizations (OPOs) and establishes a process, based 
upon sound medical criteria, for the certification and recertification 
of OPOs. The legislation further provides an opportunity for OPOs that 
fail to meet standards to implement a corrective plan of action.
  Our legislation implements the recommendations of the Institute of 
Medicine through the creation of an advisory board to review OPTN 
policies and ensure the best performance of the OPTN in the effective 
and equitable procurement and allocation of donated organs. The 
legislation also includes a provision to reimburse individuals who 
donate organs for the non-medical travel expenses and maintains the 
current standard of enduring that patients have the best data and 
information about the nation's organ transplant system. Finally, Mr. 
Speaker, as with the current law, our legislation provides that the 
OPTN will continue to be operated by a private non-profit organization, 
with rules that will be subject to review by the Secretary of Health 
and Human Services.
  Mr. Speaker, the legislation that Congressman LaHood and I have 
introduced today is a sound compromise worthy of consideration. I hope 
that our colleagues will join us in support of this legislation.

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