ESTABLISHMENT OF A NATIONAL BONE MARROW DONOR REGISTRY.

SEC. 101. ESTABLISHMENT OF A NATIONAL BONE MARROW DONOR REGISTRY. (a) Registry.—Title III of the Public Health Service Act (42 U.S.C. 301 et seq.) is amended— (1) by redesignating parts I, J, and K as parts J, K, and L, respectively; and (2) by inserting after section 377 (as added by section 207 of this Act) the following new part: “PART I—NATIONAL BONE MARROW DONOR REGISTRY “SEC. 379. NATIONAL REGISTRY. “(a) Establishment.—The Secretary shall by contract establish and maintain a National Bone Marrow Donor Registry (referred to in this part as the ‘Registry’) that meets the requirements of this 104 STAT. 3280section. The Registry shall be under the general supervision of the Secretary, and under the direction of a board of directors that shall include representatives of marrow donor centers, marrow transplant centers, persons with expertise in the social science, and the general public. “(b) Functions.—The Registry shall— “(1) establish a system for finding marrow donors suitably matched to unrelated recipients for bone marrow transplantation; “(2) establish a system for patient advocacy, separate from mechanisms for donor advocacy, that directly assists patients, their families, and their physicians in the search for an unrelated marrow donor; “(3) increase the representation of individuals from racial and ethnic minority groups in the pool of potential donors for the Registry in order to enable an individual in a minority group, to the extent practicable, to have a comparable chance of finding a suitable unrelated donor as would an individual not in a minority group; “(4) provide information to physicians, other health care professionals, and the public regarding bone marrow transplantation; “(5) recruit potential bone marrow donors; “(6) collect, analyze, and publish data concerning bone marrow donation and transplantation; and “(7) support studies and demonstration projects for the purpose of increasing the number of individuals, especially minorities, who are willing to be marrow donors. “(c) Criteria, Standards, and Procedures.—Not later than 180 days after the date of enactment of this part, the Secretary shall establish and enforce, for entities participating in the program, including the Registry, 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 dis-eases 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 that require the provision of information to patients, their families, and their physicians at the start of the search process concerning— “(A) the resources available through the Registry; “(B) all other marrow donor registries meeting the standards described in this paragraph; and “(C) in the case of the Registry— “(i) the comparative costs of all charges by marrow transplant centers incurred by patients prior to transplantation; and “(ii) the success rates of individual marrow trans-plant centers; “(5) standards that— 104 STAT. 3281 “(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 Registry. “(d) Comment Procedures.—The Secretary shall establish and provide information to the public on procedures, which may include establishment of a policy advisory committee, under which the Secretary shall receive and consider comments from interested persons relating to the manner in which the Registry is carrying out the duties of the Registry under subsection (b) and complying with the criteria, standards, and procedures described in subsection (c). “(e) Consultation—The Secretary shall consult with the board of directors of the Registry and the bone marrow donor program of the Department of the Navy in developing policies affecting the Registry. “(f) 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. “(g) Eligibility.—Entities eligible to receive a contract under this section shall include private nonprofit entities. “(h) Records.— “(1) Recordkeeping.—Each recipient of a contract or sub-contract 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. “(i) Penalties for Disclosure.—Any person who discloses the content of any record referred to in subsection (c)(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 (c)(5)(B), shall be imprisoned for not more than 2 years or fined in accordance with title 18, United States Code, or both. “(j) Authorization of Appropriations.—There are authorized to be appropriated to carry out this section $15,000,000 for fiscal year 1991 and such sums as may be necessary for each of fiscal years 1992 and 1993. 104 STAT. 3282 “SEC. 379A. STUDY BY THE GENERAL ACCOUNTING OFFICE. “(a) In General.—The Comptroller General of the United States shall conduct a study that evaluates— “(1) the costs and benefits of the search process for an unrelated bone marrow donor among different marrow donor registries; “(2) the extent to which marrow donor registries protect donor confidentiality; “(3) the relationship between the Registry, individual marow donor centers, and other marrow donor registries; “(4) the effectiveness and appropriateness of policies and procedures of marrow donor centers, marrow transplant centers, and marrow donor registries, including— “(A) the process of donor recruitment, including the policy of asking each donor whether the donor would want to donate more than one time; “(B) the maintenance and updating of donor files; and “(C) the policy of initially typing donors for A/B antigens only instead of initially typing for both A/B and D/R antigens; “(5) the ability of the marrow donor registries to incorporate changes in medical research and clinical practice; and “(6) the costs associated with tissue typing. “(b) Report.—Not later than 1 year after the date of enactment of this part, the Comptroller General shall complete the study required under subsection (a) and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Labor and Human Resources of the Senate a report describing the findings made by the study and recommendations for legislative reform.”. (b) Conforming Amendment.—Section 373 of the Act (42 U.S.C. 274a) is amended— (1) in the section heading, by striking “and Bone Marrow Registry”; (2) by striking “(a)”; and (3) by striking out subsection (b).