[Congressional Record (Bound Edition), Volume 147 (2001), Part 2]
[House]
[Pages 3042-3048]
[From the U.S. 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--

[[Page 3043]]

       ``(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 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

[[Page 3044]]

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 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

[[Page 3045]]

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 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,

[[Page 3046]]

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 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

[[Page 3047]]

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 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.

[[Page 3048]]

  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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