Stem Cell Therapeutic and Research Act of 2005 - (Sec. 2) Requires the Secretary of Health and Human Services to contract with qualified cord blood stem cell banks to assist in the collection and maintenance of 150,000 new units of high-quality cord blood to be made available for transplantation through the C.W. Bill Young Cell Transplantation Program. Requires the Secretary to require that contract recipients: (1) acquire, tissue-type, test, cryopreserve, and store donated units of human cord blood acquired with the informed consent of the donor in a manner that complies with federal and state regulations; (2) encourage donation from a genetically diverse population; (3) make collected cord blood units available for stem cell transplantation or, if not appropriate for clinical use, available for peer-reviewed research; (4) make data available in a standardized electronic format for the Program; and (5) submit data in a standardized format for inclusion in the stem cell therapeutics outcome database.
Requires the Secretary to establish a three-year demonstration project under which qualified cord blood banks may use a portion of the funding received under a contract for the collection and storage of cord blood units for a family where a relative has been diagnosed with a condition that will benefit from transplantation at no cost to such family. Excludes cord blood collected under such project from the 150,000 units to be collected for the Program. Sets forth reporting requirements.
Establishes ten years as the term of such Program contracts. Requires the Secretary to give preference to qualified cord blood banks that have demonstrated a superior ability to satisfy the requirements and achieve the contract goals. Authorizes appropriations.
Amends the Public Health Service Act to rewrite provisions requiring the Secretary to establish and maintain a National Bone Marrow Donor Registry to require the Secretary, acting through the Administrator of the Health Resources and Services Administration (HRSA), to establish and maintain the C.W. Bill Young Cell Transplantation Program to increase the number of transplants for recipients suitably matched to biologically unrelated donors of bone marrow and cord blood. Requires the Secretary to establish a related advisory council on Program activities.
Requires the Secretary to: (1) recognize one or more accreditation entities for the accreditation of cord blood banks; and (2) examine issues of informed consent, including the timing of such consent and the information provided to the maternal donor regarding all of her medically appropriate cord blood options.
Adds as Program requirements with respect to bone marrow: (1) permitting transplant physicians, other health care professionals, and patients to search by means of electronic access all available bone marrow donors listed in the Program; (2) maintaining and expanding medical contingency response capabilities to prepare for and respond effectively to biological, chemical, or radiological attacks, and other public health emergencies that can damage marrow, so that the capability of supporting patients with marrow damage from disease can be used to support casualties with marrow damage; and (3) facilitating research with federal agencies to improve the availability, efficiency, safety, and cost of transplants from unrelated donors and the effectiveness of Program operations.
Sets forth Program requirements with respect to cord blood, including: (1) operating a system for identifying, matching, and facilitating the distribution from a qualified cord blood bank of donated cord blood units that are suitably matched to candidate patients and meet all applicable federal and state regulations; (2) allowing transplant physicians, other health care professionals, and patients to search by means of electronic access all available cord blood units made available through the Program; (3) allowing transplant physician and other health care professionals to reserve a cord blood unit for transplantation; (4) supporting studies and demonstration and outreach projects for the purpose of increasing cord blood donation to ensure a genetically diverse collection of cord blood units; (5) providing for a system of patient advocacy; (6) coordinating with the qualified cord blood banks to support informational and educational activities; (7) maintaining and expanding medical contingency response capabilities to prepare for and respond to biological, chemical, or radiological attacks, and other public health emergencies that can damage marrow; and (8) collecting, analyzing, and publishing data in a standardized electronic format on the number and percentage of patients at each of the various stages of the search process.
Requires the Secretary to: (1) ensure that health care professionals and patients are able to search electronically for and facilitate access to cells from bone marrow donors and cord blood units through a single point of access; and (2) require all contract recipients under this Act to make data available in a standardized electronic format that enables transplant physicians to compare among bone marrow donors and cord blood units to ensure the best possible match for the patient.
Requires the Program to carry out activities for the recruitment of bone marrow donors and cord blood donors, including by (1) identifying populations that are underrepresented among potential donors enrolled with the Program; (2) giving priority to increasing representation for such populations; and (3) considering racial and ethnic minority groups to be such populations.
Requires the Program to carry out informational and educational activities to recruit individuals to serve as donors of bone marrow and pregnant women to serve as donors of cord blood, including by: (1) making information available to the general public; (2) educating and providing information to potential donors; (3) training individuals in requesting donors; (4) giving priority to recruiting donors for underrepresented populations; and (5) providing information to physicians, other health care professionals, and the public regarding bone marrow transplants from unrelated donors and cord blood transplants for donors as treatment options.
Requires the Secretary to enforce for participating entities: (1) quality standards and standards for tissue-typing, obtaining the informed consent of donors, and providing patient advocacy; (2) donor selection criteria to protect both the donor and the recipient and to prevent the transmission of potentially harmful infectious diseases; (3) procedures to ensure the proper collection and transportation of the marrow; (4) standards for patient advocacy; and (5) confidentiality standards.
Requires the Secretary to establish and maintain an office of patient advocacy to: (1) operate a system for patient advocacy to serve patients for whom the Program is searching for a bone marrow donor or cord blood unit; (2) serve as an advocate for the patient by directly providing individualized services on the efficient utilization of the system to conduct an ongoing search and assist with information regarding third party payors; (3) monitor the searching system to determine whether the needs of the patient involved are being met; (4) conduct surveys of patients, family members, physicians, or other individuals acting on behalf of a patient to determine the extent of satisfaction with the system for patient advocacy; (5) provide individualized case management services; and (6) provide information and education on the process of receiving a transplant after a completed search.
Requires the Secretary to give consideration to the continued safety of donors and patients and other factors in awarding contracts under this Act. Requires contract recipients to keep records. Prescribes criminal penalties for violations of confidentiality provisions.
Requires the Secretary to establish and maintain a scientific database of information relating to recipients of a stem cell therapeutics product, including bone marrow and cord blood, from a donor. Requires the database to make relevant scientific information not containing individually identifiable information available to the public to encourage medical research and to provide information to interested parties.
Authorizes appropriations.
(Sec. 4) Requires the Secretary to submit to Congress a report on the progress made by the Food and Drug Administration (FDA) in developing requirements for the licensing of cord blood units.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1317 Introduced in Senate (IS)]
109th CONGRESS
1st Session
S. 1317
To provide for the collection and maintenance of cord blood units for
the treatment of patients and research, and to amend the Public Health
Service Act to authorize the Bone Marrow and Cord Blood Cell
Transplantation Program to increase the number of transplants for
recipients suitably matched to donors of bone marrow and cord blood.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 27, 2005
Mr. Hatch (for himself, Mr. Dodd, Mr. Burr, Mr. Reed, and Mr. Ensign)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To provide for the collection and maintenance of cord blood units for
the treatment of patients and research, and to amend the Public Health
Service Act to authorize the Bone Marrow and Cord Blood Cell
Transplantation Program to increase the number of transplants for
recipients suitably matched to donors of bone marrow and cord blood.
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 ``Bone Marrow and Cord Blood Therapy
and Research Act of 2005''.
SEC. 2. CORD BLOOD INVENTORY.
(a) In General.--The Secretary of Health and Human Services shall
enter into one-time contracts with qualified cord blood banks to assist
in the collection and maintenance of 150,000 new units of high-quality
cord blood to be made available for transplantation through the Bone
Marrow and Cord Blood Cell Transplantation Program and to carry out the
requirements of subsection (b).
(b) Requirements.--The Secretary shall require each recipient of a
contract under this section--
(1) to acquire, tissue-type, test, cryopreserve, and store
donated units of cord blood acquired with the informed consent
of the donor in a manner that complies with applicable Federal
and State regulations;
(2) to encourage donation from a genetically diverse
population;
(3) to make cord blood units that are collected pursuant to
this section or otherwise and meet all applicable Federal
standards available to transplant centers for transplantation;
(4) to make cord blood units that are collected, but not
appropriate for clinical use, available for peer-reviewed
research;
(5) to make data available, as required by the Secretary
and consistent with section 379(c)(3) of the Public Health
Service Act (42 U.S.C. 274k(c)(3)), as amended by this Act, in
a standardized electronic format, as determined by the
Secretary, for the Bone Marrow and Cord Blood Cell
Transplantation Program; and
(6) to submit data in a standardized electronic format for
inclusion in the stem cell therapeutic outcomes database
maintained under section 379A of the Public Health Service Act,
as amended by this Act.
(c) Related Cord Blood Donors.--
(1) In general.--The Secretary shall establish a 3-year
demonstration project under which qualified cord blood banks
receiving a contract under this section may use a portion of
the funding under such contract for the collection and storage
of cord blood units for a family where a first-degree relative
has been diagnosed with a condition that will benefit from
transplantation (including selected blood disorders,
malignancies, metabolic storage disorders, hemoglobinopathies,
and congenital immunodeficiencies) at no cost to such family.
Qualified cord blood banks collecting cord blood units under
this paragraph shall comply with the requirements of paragraphs
(1), (2), (3), and (5) of subsection (b).
(2) Availability.--Qualified cord blood banks that are
operating a program under paragraph (1) shall provide
assurances that the cord blood units in such banks will be
available for directed transplantation until such time that the
cord blood unit is released for transplantation or is
transferred by the family to the Bone Marrow and Cord Blood
Cell Transplantation Program in accordance with guidance or
regulations promulgated by the Secretary.
(3) Inventory.--Cord blood units collected through the
program under this section shall not be counted toward the
150,000 inventory goal under the Bone Marrow and Cord Blood
Cell Transplantation Program.
(4) Report.--Not later than 90 days after the date on which
the project under paragraph (1) is terminated by the Secretary,
the Secretary shall submit to Congress a report on the outcomes
of the project that shall include the recommendations of the
Secretary with respect to the continuation of such project.
(d) Application.--To seek to enter into a contract under this
section, a qualified cord blood bank shall submit an application to the
Secretary at such time, in such manner, and containing such information
as the Secretary may reasonably require. At a minimum, an application
for a contract under this section shall include a requirement that the
applicant--
(1) will participate in the Bone Marrow and Cord Blood Cell
Transplantation Program for a period of at least 10 years;
(2) will make cord blood units collected pursuant to this
section available through the Bone Marrow and Cord Blood Cell
Transplantation Program in perpetuity; and
(3) if the Secretary determines through an assessment, or
through petition by the applicant, that a cord blood bank is no
longer operational or does not meet the requirements of section
379(c)(4) of the Public Health Service Act (as added by this
Act) and as a result may not distribute the units, transfer the
units collected pursuant to this section to another qualified
cord blood bank approved by the Secretary to ensure continued
availability of cord blood units.
(e) Duration of Contracts.--
(1) In general.--Except as provided in paragraph (2), the
term of each contract entered into by the Secretary under this
section shall be for 10 years. The Secretary shall ensure that
Federal funds provided under any such contract terminate on the
earlier of--
(A) the date that is 3 years after the date on
which the contract is entered into; or
(B) September 30, 2010.
(2) Extensions.--Subject to paragraph (1)(B), the Secretary
may extend the period of funding under a contract under this
section to exceed a period of 3 years if--
(A) the Secretary finds that 150,000 new units of
high-quality cord blood have not yet been collected
pursuant to this section; and
(B) the Secretary does not receive an application
for a contract under this section from any qualified
cord blood bank that has not previously entered into a
contract under this section or the Secretary determines
that the outstanding inventory need cannot be met by
the one or more qualified cord blood banks that have
submitted an application for a contract under this
section.
(3) Preference.--In considering contract extensions under
paragraph (2), the Secretary shall give preference to qualified
cord blood banks that the Secretary determines have
demonstrated a superior ability to satisfy the requirements
described in subsection (b) and to achieve the overall goals
for which the contract was awarded.
(f) Regulations.--The Secretary may promulgate regulations to carry
out this section.
(g) Definitions.--In this section:
(1) The term ``Bone Marrow and Cord Blood Cell
Transplantation Program'' means the Bone Marrow and Cord Blood
Cell Transplantation Program under section 379 of the Public
Health Service Act, as amended by this Act.
(2) The term ``cord blood donor'' means a mother who has
delivered a baby and consents to donate the neonatal blood
remaining in the placenta and umbilical cord after separation
from the newborn baby.
(3) The term ``cord blood unit'' means the neonatal blood
collected from the placenta and umbilical cord of a single
newborn baby.
(4) The term ``first-degree relative'' means a sibling or
parent who is one meiosis away from a particular individual in
a family.
(5) The term ``qualified cord blood bank'' has the meaning
given to that term in section 379(c)(4) of the Public Health
Service Act, as amended by this Act.
(6) The term ``Secretary'' means the Secretary of Health
and Human Services.
(h) Authorization of Appropriations.--
(1) Existing funds.--Any amounts appropriated to the
Secretary for fiscal year 2004 or 2005 for the purpose of
assisting in the collection or maintenance of cord blood shall
remain available to the Secretary until the end of fiscal year
2007.
(2) Subsequent fiscal years.--There are authorized to be
appropriated to the Secretary $15,000,000 for each of fiscal
years 2007, 2008, 2009, and 2010 to carry out this section.
(3) Limitation.--Not to exceed 5 percent of the amount
appropriated under this section in each of fiscal years 2007
through 2009 may be used to carry out the demonstration project
under subsection (c).
SEC. 3. BONE MARROW AND CORD BLOOD CELL TRANSPLANTATION PROGRAM.
(a) National Program.--Section 379 of the Public Health Service Act
(42 U.S.C. 274k) is amended to read as follows:
``SEC. 379. NATIONAL PROGRAM.
``(a) Establishment.--The Secretary, acting through the
Administrator of the Health Resources and Services Administration,
shall by one or more contracts establish and maintain a Bone Marrow and
Cord Blood Cell Transplantation Program (referred to in this section as
the `Program') that has the purpose of increasing the number of
transplants for recipients suitably matched to biologically unrelated
donors of bone marrow and cord blood, and that meets the requirements
of this section. The Secretary may award a separate contract to perform
each of the major functions of the Program described in paragraphs (1)
and (2) of subsection (c) if deemed necessary by the Secretary to
operate an effective and efficient system that is in the best interest
of patients. The Secretary shall conduct a separate competition for the
initial establishment of the cord blood functions of the Program. The
Program shall be under the general supervision of the Secretary. The
Secretary shall establish an Advisory Council to advise, assist,
consult with, and make recommendations to the Secretary on matters
related to the activities carried out by the Program. The members of
the Advisory Council shall be appointed in accordance with the
following:
``(1) Each member of the Advisory Council shall serve for a
term of 2 years, and each such member may serve as many as 3
consecutive 2-year terms, except that
``(A) such limitations shall not apply to the Chair
of the Advisory Council (or the Chair-elect) or to the
member of the Advisory Council who most recently served
as the Chair; and
``(B) 1 additional consecutive 2-year term may be
served by any member of the Advisory Council who has no
employment, governance, or financial affiliation with
any donor center, recruitment organization, transplant
center, or cord blood bank.
``(2) A member of the Advisory Council may continue to
serve after the expiration of the term of such member until a
successor is appointed.
``(3) In order to ensure the continuity of the Advisory
Council, the Advisory Council shall be appointed so that each
year the terms of approximately one-third of the members of the
Advisory Council expire.
``(4) The membership of the Advisory Council--
``(A) shall include as voting members a balanced
number of representatives including representatives of
marrow donor centers and marrow transplant centers,
representatives of cord blood banks and participating
birthing hospitals, recipients of a bone marrow
transplant, recipients of a cord blood transplant,
persons who require such transplants, family members of
such a recipient or family members of a patient who has
requested the assistance of the Program in searching
for an unrelated donor of bone marrow or cord blood,
persons with expertise in bone marrow and cord blood
transplantation, persons with expertise in typing,
matching, and transplant outcome data analysis, persons
with expertise in the social sciences, basic scientists
with expertise in the biology of adult stem cells, and
members of the general public; and
``(B) shall include as nonvoting members
representatives from the Department of Defense Marrow
Donor Recruitment and Research Program operated by the
Department of the Navy, the Division of Transplantation
of the Health Resources and Services Administration,
the Food and Drug Administration, and the National
Institutes of Health.
``(5) Members of the Advisory Council shall be chosen so as
to ensure objectivity and balance and reduce the potential for
conflicts of interest. The Secretary shall establish bylaws and
procedures--
``(A) to prohibit any member of the Advisory
Council who has an employment, governance, or financial
affiliation with a donor center, recruitment
organization, transplant center, or cord blood bank
from participating in any decision that materially
affects the center, recruitment organization,
transplant center, or cord blood bank; and
``(B) to limit the number of members of the
Advisory Council with any such affiliation.
``(6) The Secretary, acting through the Advisory Council,
shall submit to the Congress--
``(A) an annual report on the activities carried
out under this section; and
``(B) not later than 6 months after the date of the
enactment of the Bone Marrow and Cord Blood Therapy and
Research Act of 2005, a report of recommendations on
the scientific factors necessary to define a cord blood
unit as a high-quality unit.
``(b) Accreditation.--The Secretary shall, through a public
process, recognize one or more accreditation entities for the
accreditation of cord blood banks.
``(c) Functions.--
``(1) Bone marrow functions.--With respect to bone marrow,
the Program shall--
``(A) operate a system for listing, searching, and
facilitating the distribution of bone marrow that is
suitably matched to candidate patients;
``(B) consistent with paragraph (3), permit
transplant physicians, other appropriate health care
professionals, and patients to search by means of
electronic access all available bone marrow donors
listed in the Program;
``(C) carry out a program for the recruitment of
bone marrow donors in accordance with subsection (d),
including with respect to increasing the representation
of racial and ethnic minority groups (including persons
of mixed ancestry) in the enrollment of the Program;
``(D) maintain and expand medical contingency
response capabilities, in coordination with Federal
programs, to prepare for and respond effectively to
biological, chemical, or radiological attacks, and
other public health emergencies that can damage marrow,
so that the capability of supporting patients with
marrow damage from disease can be used to support
casualties with marrow damage;
``(E) carry out informational and educational
activities in accordance with subsection (d);
``(F) at least annually update information to
account for changes in the status of individuals as
potential donors of bone marrow;
``(G) provide for a system of patient advocacy
through the office established under subsection (g);
``(H) provide case management services for any
potential donor of bone marrow to whom the Program has
provided a notice that the potential donor may be
suitably matched to a particular patient through the
office established under subsection (g);
``(I) with respect to searches for unrelated donors
of bone marrow that are conducted through the system
under subparagraph (A), collect, analyze, and publish
data in a standardized electronic format on the number
and percentage of patients at each of the various
stages of the search process, including data regarding
the furthest stage reached, the number and percentage
of patients who are unable to complete the search
process, and the reasons underlying such circumstances;
``(J) support studies and demonstration and
outreach projects for the purpose of increasing the
number of individuals who are willing to be marrow
donors to ensure a genetically diverse donor pool; and
``(K) facilitate and support research to improve
the availability, efficiency, safety, and cost of
transplants from unrelated donors and the effectiveness
of Program operations.
``(2) Cord blood functions.--With respect to cord blood,
the Program shall--
``(A) operate a system for listing, searching, and
facilitating the distribution of donated cord blood
units that are suitably matched to candidate patients
and meet all applicable Federal and State regulations
(including informed consent and Food and Drug
Administration regulations) from a qualified cord blood
bank;
``(B) consistent with paragraph (3), allow
transplant physicians, other appropriate health care
professionals, and patients to search by means of
electronic access all available cord blood units made
available through the Program;
``(C) allow transplant physicians and other
appropriate health care professionals to reserve, as
defined by the Secretary, a cord blood unit for
transplantation;
``(D) support studies and demonstration and
outreach projects for the purpose of increasing cord
blood donation to ensure a genetically diverse
collection of cord blood units;
``(E) provide for a system of patient advocacy
through the office established under subsection (g);
``(F) coordinate with the qualified cord blood
banks to carry out informational and educational
activities in accordance with subsection (f);
``(G) maintain and expand medical contingency
response capabilities, in coordination with Federal
programs, to prepare for and respond effectively to
biological, chemical, or radiological attacks, and
other public health emergencies that can damage marrow,
so that the capability of supporting patients with
marrow damage from disease can be used to support
casualties with marrow damage; and
``(H) with respect to the system under subparagraph
(A), collect, analyze, and publish data in a
standardized electronic format, as required by the
Secretary, on the number and percentage of patients at
each of the various stages of the search process,
including data regarding the furthest stage reached,
the number and percentage of patients who are unable to
complete the search process, and the reasons underlying
such circumstances.
``(3) Single point of access; submission of data.--
``(A) Single point of access.--The Secretary shall
ensure that health care professionals and patients are
able to, at a minimum, locate, consistent with the
functions described in paragraphs (1)(A) and (2)(A),
cells from bone marrow donors and cord blood units
through a single electronic point of access.
``(B) Standard data.--The Secretary shall require
all recipients of contracts under this section to make
available a standard dataset for purposes of
subparagraph (A) in a standardized electronic format
the enables transplant physicians to compare among and
between bone marrow donors and cord blood units to
ensure the best possible match for the patient.
``(4) Definition.--The term `qualified cord blood bank'
means a cord blood bank that--
``(A) has obtained all applicable Federal and State
licenses, certifications, registrations (including
pursuant to the regulations of the Food and Drug
Administration), and other authorizations required to
operate and maintain a cord blood bank;
``(B) has implemented donor screening, cord blood
collection practices, and processing methods intended
to protect the health and safety of donors and
transplant recipients to improve transplant outcomes,
including with respect to the transmission of
potentially harmful infections and other diseases;
``(C) is accredited by an accreditation entity
recognized by the Secretary under subsection (b);
``(D) has established a system of strict
confidentiality to protect the identity and privacy of
patients and donors in accordance with existing Federal
and State law;
``(E) has established a system for encouraging
donation by a genetically diverse group of donors; and
``(F) has established a system to confidentially
maintain linkage between a cord blood unit and a
maternal donor.
``(d) Bone Marrow Recruitment; Priorities; Information and
Education.--
``(1) Recruitment; priorities.--The Program shall carry out
activities for the recruitment of bone marrow donors. Such
recruitment program shall identify populations that are
underrepresented among potential donors enrolled with the
Program. In the case of populations that are identified under
the preceding sentence:
``(A) The Program shall give priority to carrying
out activities under this part to increase
representation for such populations in order to enable
a member of such a population, to the extent
practicable, to have a probability of finding a
suitable unrelated donor that is comparable to the
probability that an individual who is not a member of
an underrepresented population would have.
``(B) The Program shall consider racial and ethnic
minority groups (including persons of mixed ancestry)
to be populations that have been identified for
purposes of this paragraph, and shall carry out
subparagraph (A) with respect to such populations.
``(2) Information and education regarding recruitment;
testing and enrollment.--
``(A) In general.--The Program shall carry out
informational and educational activities, in
coordination with organ donation public awareness
campaigns operated through the Department of Health and
Human Services, for purposes of recruiting individuals
to serve as donors of bone marrow, and shall test and
enroll with the Program potential bone marrow donors.
Such information and educational activities shall
include the following:
``(i) Making information available to the
general public, including information
describing the needs of patients with respect
to donors of bone marrow.
``(ii) Educating and providing information
to individuals who are willing to serve as
potential bone marrow donors.
``(iii) Training individuals in requesting
individuals to serve as potential bone marrow
donors.
``(B) Priorities.--In carrying out informational
and educational activities under subparagraph (A), the
Program shall give priority to recruiting individuals
to serve as donors of bone marrow for populations that
are identified under paragraph (1).
``(3) Transplantation as treatment option.--In addition to
activities regarding recruitment, the recruitment program under
paragraph (1) shall provide information to physicians, other
health care professionals, and the public regarding bone marrow
transplants from unrelated donors as a treatment option.
``(4) Implementation of subsection.--The requirements of
this subsection shall be carried out by the entity that has
been awarded a contract by the Secretary under subsection (a)
to carry out the functions described in subsection (c)(1).
``(e) Bone Marrow Criteria, Standards, and Procedures.--The
Secretary shall enforce, for participating entities, including the
Program, individual marrow donor centers, marrow donor registries,
marrow collection centers, and marrow transplant centers--
``(1) quality standards and standards for tissue typing,
obtaining the informed consent of donors, and providing patient
advocacy;
``(2) donor selection criteria, based on established
medical criteria, to protect both the donor and the recipient
and to prevent the transmission of potentially harmful
infectious diseases such as the viruses that cause hepatitis
and the etiologic agent for Acquired Immune Deficiency
Syndrome;
``(3) procedures to ensure the proper collection and
transportation of the marrow;
``(4) standards for the system for patient advocacy
operated under subsection (g), including standards requiring
the provision of appropriate information (at the start of the
search process and throughout the process) to patients and
their families and physicians;
``(5) standards that--
``(A) require the establishment of a system of
strict confidentiality of records relating to the
identity, address, HLA type, and managing marrow donor
center for marrow donors and potential marrow donors;
and
``(B) prescribe the purposes for which the records
described in subparagraph (A) may be disclosed, and the
circumstances and extent of the disclosure; and
``(6) in the case of a marrow donor center or marrow donor
registry participating in the program, procedures to ensure the
establishment of a method for integrating donor files,
searches, and general procedures of the center or registry with
the Program.
``(f) Cord Blood Recruitment; Priorities; Information and
Education.--
``(1) Recruitment; priorities.--The Program shall support
activities, in cooperation with qualified cord blood banks, for
the recruitment of cord blood donors. Such recruitment program
shall identify populations that are underrepresented among cord
blood donors. In the case of populations that are identified
under the preceding sentence:
``(A) The Program shall give priority to supporting
activities under this part to increase representation
for such populations in order to enable a member of
such a population, to the extent practicable, to have a
probability of finding a suitable cord blood unit that
is comparable to the probability that an individual who
is not a member of an underrepresented population would
have.
``(B) The Program shall consider racial and ethnic
minority groups (including persons of mixed ancestry)
to be populations that have been identified for
purposes of this paragraph, and shall support
activities under subparagraph (A) with respect to such
populations.
``(2) Information and education regarding recruitment;
testing and donation.--
``(A) In general.--In carrying out the recruitment
program under paragraph (1), the Program shall support
informational and educational activities in
coordination with qualified cord blood banks and organ
donation public awareness campaigns operated through
the Department of Health and Human Services, for
purposes of recruiting pregnant women to serve as
donors of cord blood. Such information and educational
activities shall include the following:
``(i) Making information available to the
general public, including information
describing the needs of patients with respect
to cord blood units.
``(ii) Educating and providing information
to pregnant women who are willing to donate
cord blood units.
``(iii) Training individuals in requesting
pregnant women to serve as cord blood donors.
``(B) Priorities.--In carrying out informational
and educational activities under subparagraph (A), the
Program shall give priority to supporting the
recruitment of pregnant women to serve as donors of
cord blood for populations that are identified under
paragraph (1).
``(3) Transplantation as treatment option.--In addition to
activities regarding recruitment, the recruitment program under
paragraph (1) shall provide information to physicians, other
health care professionals, and the public regarding cord blood
transplants from donors as a treatment option.
``(4) Implementation of subsection.--The requirements of
this subsection shall be carried out by the entity that has
been awarded a contract by the Secretary under subsection (a)
to carry out the functions described in subsection (c)(2).
``(g) Patient Advocacy and Case Management for Bone Marrow and Cord
Blood.--
``(1) In general.--The Secretary shall establish and
maintain, through a contract or other means determined
appropriate by the Secretary, an office of patient advocacy (in
this subsection referred to as the `Office').
``(2) General functions.--The Office shall meet the
following requirements:
``(A) The Office shall be headed by a director.
``(B) The Office shall be staffed by individuals
with expertise in bone marrow and cord blood therapy
covered under the Program.
``(C) The Office shall operate a system for patient
advocacy, which shall be separate from mechanisms for
donor advocacy, and which shall serve patients for whom
the Program is conducting, or has been requested to
conduct, a search for a bone marrow donor or cord blood
unit.
``(D) In the case of such a patient, the Office
shall serve as an advocate for the patient by directly
providing to the patient (or family members,
physicians, or other individuals acting on behalf of
the patient) individualized services with respect to
efficiently utilizing the system under paragraphs (1)
and (2) of subsection (c) to conduct an ongoing search
for a bone marrow donor or cord blood unit and assist
with information regarding third party payor matters.
``(E) In carrying out subparagraph (D), the Office
shall monitor the system under paragraphs (1) and (2)
of subsection (c) to determine whether the search needs
of the patient involved are being met, including with
respect to the following:
``(i) Periodically providing to the patient
(or an individual acting on behalf of the
patient) information regarding bone marrow
donors or cord blood units that are suitably
matched to the patient, and other information
regarding the progress being made in the
search.
``(ii) Informing the patient (or such other
individual) if the search has been interrupted
or discontinued.
``(iii) Identifying and resolving problems
in the search, to the extent practicable.
``(F) The Office shall ensure that the following
data are made available to patients:
``(i) The resources available through the
Program.
``(ii) A comparison of transplant centers
regarding search and other costs that prior to
transplantation are charged to patients by
transplant centers.
``(iii) The post-transplant outcomes for
individual transplant centers.
``(iv) Information concerning issues that
patients may face after a transplant.
``(v) Such other information as the Program
determines to be appropriate.
``(G) The Office shall conduct surveys of patients
(or family members, physicians, or other individuals
acting on behalf of patients) to determine the extent
of satisfaction with the system for patient advocacy
under this subsection, and to identify ways in which
the system can be improved to best meet the needs of
patients.
``(3) Case management.--
``(A) In general.--In serving as an advocate for a
patient under paragraph (2), the Office shall provide
individualized case management services directly to the
patient (or family members, physicians, or other
individuals acting on behalf of the patient),
including--
``(i) individualized case assessment; and
``(ii) the functions described in paragraph
(2)(D) (relating to progress in the search
process).
``(B) Postsearch functions.--In addition to the
case management services described in paragraph (1) for
patients, the Office shall, on behalf of patients who
have completed the search for a bone marrow donor or
cord blood unit, provide information and education on
the process of receiving a transplant, including the
post-transplant process.
``(h) Comment Procedures.--The Secretary shall establish and
provide information to the public on procedures under which the
Secretary shall receive and consider comments from interested persons
relating to the manner in which the Program is carrying out the duties
of the Program.
``(i) Consultation.--In developing policies affecting the Program,
the Secretary shall consult with the Advisory Council, the Department
of Defense Marrow Donor Recruitment and Research Program operated by
the Department of the Navy, and the board of directors of each entity
awarded a contract under this section.
``(j) Contracts.--
``(1) Application.--To be eligible to enter into a contract
under this section, an entity shall submit to the Secretary and
obtain approval of an application at such time, in such manner,
and containing such information as the Secretary shall by
regulation prescribe.
``(2) Considerations.--In awarding contracts under this
section, the Secretary shall give consideration to the
continued safety of donors and patients and other factors
deemed appropriate by the Secretary.
``(k) Eligibility.--Entities eligible to receive a contract under
this section shall include private nonprofit entities.
``(l) Records.--
``(1) Recordkeeping.--Each recipient of a contract or
subcontract under subsection (a) shall keep such records as the
Secretary shall prescribe, including records that fully
disclose the amount and disposition by the recipient of the
proceeds of the contract, the total cost of the undertaking in
connection with which the contract was made, and the amount of
the portion of the cost of the undertaking supplied by other
sources, and such other records as will facilitate an effective
audit.
``(2) Examination of records.--The Secretary and the
Comptroller General of the United States shall have access to
any books, documents, papers, and records of the recipient of a
contract or subcontract entered into under this section that
are pertinent to the contract, for the purpose of conducting
audits and examinations.
``(m) Penalties for Disclosure.--Any person who discloses the
content of any record referred to in subsection (c)(4)(D) or (e)(5)(A)
without the prior written consent of the donor or potential donor with
respect to whom the record is maintained, or in violation of the
standards described in subsection (e)(5)(B), shall be imprisoned for
not more than 2 years or fined in accordance with title 18, United
States Code, or both.''.
(b) Stem Cell Therapeutic Outcomes Database.--Section 379A of the
Public Health Service Act (42 U.S.C. 274l) is amended to read as
follows:
``SEC. 379A. STEM CELL THERAPEUTIC OUTCOMES DATABASE.
``(a) Establishment.--The Secretary shall by contract establish and
maintain a scientific database of information relating to patients who
have been recipients of a stem cell therapeutics product (including
bone marrow, cord blood, or other such product) from a donor.
``(b) Information.--The outcomes database shall include information
in a standardized electronic format with respect to patients described
in subsection (a), diagnosis, transplant procedures, results, long-term
follow-up, and such other information as the Secretary determines to be
appropriate, to conduct an ongoing evaluation of the scientific and
clinical status of transplantation involving recipients of a stem cell
therapeutics product from a donor.
``(c) Annual Report on Patient Outcomes.--The Secretary shall
require the entity awarded a contract under this section to submit to
the Secretary an annual report concerning patient outcomes with respect
to each transplant center, based on data collected and maintained by
the entity pursuant to this section.
``(d) Publicly Available Data.--The outcomes database shall make
relevant scientific information not containing individually
identifiable information available to the public in the form of
summaries and data sets to encourage medical research and to provide
information to transplant programs, physicians, patients, entities
awarded a contract under section 379 donor registries, and cord blood
banks.''.
(c) Definitions.--Part I of title III of the Public Health Service
Act (42 U.S.C. 274k et seq.) is amended by inserting after section 379A
the following:
``SEC. 379A-1. DEFINITIONS.
``In this part:
``(1) The term `Advisory Council' means the advisory
council established by the Secretary under section 379(a)(1).
``(2) The term `bone marrow' means the cells found in adult
bone marrow and peripheral blood.
``(3) The term `outcomes database' means the database
established by the Secretary under section 379A.
``(4) The term `Program' means the Bone Marrow and Cord
Blood Cell Transplantation Program established under section
379.''.
(d) Authorization of Appropriations.--Section 379B of the Public
Health Service Act (42 U.S.C. 274m) is amended to read as follows:
``SEC. 379B. AUTHORIZATION OF APPROPRIATIONS.
``For the purpose of carrying out this part, there are authorized
to be appropriated $34,000,000 for fiscal year 2006 and $38,000,000 for
each of fiscal years 2007 through 2010.''.
(e) Conforming Amendments.--Part I of title III of the Public
Health Service Act (42 U.S.C. 274k et seq.) is amended in the part
heading, by striking ``NATIONAL BONE MARROW DONOR REGISTRY'' and
inserting ``BONE MARROW AND CORD BLOOD CELL TRANSPLANTATION PROGRAM''.
SEC. 4. REPORT ON LICENSURE OF CORD BLOOD UNITS.
Not later than 90 days after the date of enactment of this Act, the
Secretary of Health and Human Services, in consultation with the
Commissioner of Food and Drugs, shall submit to Congress a report
concerning the progress made by the Food and Drug Administration in
developing requirements for the licensing of cord blood units.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S7433)
Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S7434-7437)
Committee on Health, Education, Labor, and Pensions. Ordered to be reported with an amendment in the nature of a substitute favorably.
Committee on Health, Education, Labor, and Pensions. Reported by Senator Enzi with an amendment in the nature of a substitute. Without written report.
Committee on Health, Education, Labor, and Pensions. Reported by Senator Enzi with an amendment in the nature of a substitute. Without written report.
Placed on Senate Legislative Calendar under General Orders. Calendar No. 156.
By Senator Enzi from Committee on Health, Education, Labor, and Pensions filed written report under authority of the order of the Senate of 07/29/2005. Report No. 109-129.
By Senator Enzi from Committee on Health, Education, Labor, and Pensions filed written report under authority of the order of the Senate of 07/29/2005. Report No. 109-129.
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