Reimbursement of Travel and Subsistence Expenses toward Living Organ Donation Eligibility Guidelines, 29218-29220 [E9-14425]
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29218
Federal Register / Vol. 74, No. 117 / Friday, June 19, 2009 / Notices
Funding opportunity No.
Funding opportunity title
HHS–2009–ACF–OCSE–FD–0093 ..............................................
Partnership to Strengthen Families—Child Support Enforcement/Temporary Assistance for Needy Families—University
Partnership Demonstration Project.
Projects to Address the Sudden and Prolonged Effect of the
Economic Downturn on the IV–D Caseload and Program
Operations.
Health Care/Medical Support in Child Support Enforcement:
Reform Strategy Grants.
HHS–2009–ACF–OCSE–FD–0095 ..............................................
mstockstill on PROD1PC66 with NOTICES
HHS–2009–ACF–OCSE–FD–0098 ..............................................
Historically, the imposition of a
matching requirement on awards under
this program resulted in an increased
level of commitment to the project and
its success and sustainability, without
creating an undue financial burden on
the grantee.
Section 1115 funds awarded to each
project will represent 29 percent (29%)
of the total project costs. The total
approved project cost is the sum of the
ACF grant award under Section 1115,
regular Federal Financial Participation
(FFP), and the State share. For the
purposes of the demonstration projects,
the total expenditures will be treated as
State expenditures under Title IV–D that
will be reimbursed by the regular Title
IV–D FFP match of 66 percent (66%).
Applicants must prepare a formal
budget on the required standard forms,
as listed in Section IV.2, Content and
Form of Application Submission of the
funding opportunity announcements.
Grantees must provide at least five
percent (5%) of the total approved
project cost. This non-Federal, i.e., State
share, may be met by cash, incentive
funds (awarded under section 458 of the
Social Security Act), or in-kind
contributions. The five percent (5%)
match may be provided through in-kind
contributions, as allowed by section
1115(a)(2)(A) of the Social Security Act.
For example, if an applicant’s total
project budget is $150,000, this would
be made up of three funding sources:
Section 1115 funds (29% = $43,500),
cost sharing (5% = $7,500) and regular
Title IV–D Federal Financial
Participation/FFP (66% = $99,000).
Title IV–D applicants that anticipate
satisfying the matching requirement
through in-kind contributions, or the
use of incentive funds awarded under
section 458 of the Social Security Act,
must request prior approval as part of
the required budget justification (see
Section IV.2. Budget and Budget
Justification in the published funding
opportunity announcements) in
accordance with section 1115(a)(2)(A) of
the Social Security Act. Costs borne by
matching contributions are subject to
the regulations governing allowability
found under and 45 CFR 92.24.
VerDate Nov<24>2008
16:25 Jun 18, 2009
Jkt 217001
Eligible applicants for these Section
1115 demonstration project grants are
State (including the District of
Columbia, Guam, Puerto Rico, and the
Virgin Islands) Title IV–D agencies or
the umbrella agencies of the IV–D
program.
Planned ACF funding opportunity
announcements may be found at the
HHS Grants Forecast Web site at
https://www.hhs.gov/grantsforecast/. The
HHS’s Grants Forecast is a database of
planned funding opportunities
proposed by its operating divisions,
including ACF. Each Forecast record
contains actual or estimated dates and
funding levels for awards that an
operating division intends to award
during the fiscal year. ACF’s publicly
published funding opportunity
announcements are available on https://
www.Grants.gov, where applicants may
also apply for funding electronically,
and on the ACF Grant Opportunities
Web page at https://www.acf.hhs.gov/
grants/.
FOR FURTHER INFORMATION CONTACT:
Myles Schlank, Office of Child Support
Enforcement, 370 L’Enfant Promenade,
SW., Washington, DC 20047. Telephone:
202–401–9329, e-mail:
myles.schlank@acf.hhs.gov.
Dated: June 15, 2009.
Robert Cohen,
Acting Commissioner, Program Office: Child
Support Enforcement.
[FR Doc. E9–14363 Filed 6–18–09; 8:45 am]
BILLING CODE P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Reimbursement of Travel and
Subsistence Expenses toward Living
Organ Donation Eligibility Guidelines
AGENCY: Health Resources and Services
Administration (HRSA), HHS.
ACTION: Response to solicitation of
comments on amendment to program
follow-up period and publication of
PO 00000
Frm 00055
Fmt 4703
Sfmt 4703
CFDA No.
93.654
93.654
93.654
amended Program Eligibility
Guidelines.
SUMMARY: This notice finalizes an
amendment to the eligibility guidelines
proposed on March 4, 2009 in the
Federal Register (74 FR 9407). The
purpose of this notice was to solicit
comments on the amendment to the
Program Eligibility Guidelines proposed
by HRSA concerning the
Reimbursement of Travel and
Subsistence Expenses Program followup period.
FOR FURTHER INFORMATION CONTACT:
Richard Durbin, Director, Division of
Transplantation, Healthcare Systems
Bureau, Health Resources and Services
Administration, Parklawn Building,
Room 12C–06, 5600 Fishers Lane,
Rockville, Maryland 20857; telephone
(301) 443–7577; fax (301) 594–6095; or
E-mail: rdurbin@hrsa.gov.
SUPPLEMENTARY INFORMATION: In the
existing Program eligibility guidelines,
under the Qualifying Expenses Section,
the first paragraph states:
‘‘For the purposes of the Reimbursement of
Travel and Subsistence Expenses toward
Living Organ Donation Program, qualifying
expenses presently include only travel,
lodging, and meals and incidental expenses
incurred by the donor and/or his/her
accompanying person(s) as part of:
(1) Donor evaluation, clinic visit or
hospitalization,
(2) Hospitalization for the living donor
surgical procedure, and/or
(3) Medical or surgical follow-up clinic
visit or hospitalization within 90 days
following the living donation procedure.’’
HRSA proposed amending the first
bullet of this paragraph to read: ‘‘(1)
Donor evaluation, and/or’’. In addition,
HRSA proposed amending the third
bullet of this paragraph to read: ‘‘(3)
Medical or surgical follow-up clinic
visit or hospitalization within two
calendar years or beyond—if
exceptional circumstances exist—
following the living donation
procedure.’’ The purpose of this
proposed change was to bring the
NLDAC follow-up period in line with
the OPTN policies of a 2-year follow-up
of living organ donors.
HRSA received six public comments
on this request. All the respondents
E:\FR\FM\19JNN1.SGM
19JNN1
Federal Register / Vol. 74, No. 117 / Friday, June 19, 2009 / Notices
mstockstill on PROD1PC66 with NOTICES
support HRSA’s proposed amendment.
HRSA wishes to thank everyone who
reviewed this request even if a formal
response was not sent to HRSA.
Through this notice, HRSA approves
the amendment to the Reimbursement
of Travel and Subsistence Expenses
Program Eligibility Guidelines as
published in the Federal Register. This
document also corrects a mistake
included in the previous version of the
Guidelines concerning the proper
decision-maker on financial hardship
determinations. Finally, HRSA notes
that the grantee has the authority to
make operational decisions in
implementing the Program, such as
setting filing deadlines.
The amended eligibility criteria are
included in this document. The
amended eligibility criteria guidelines
document is also available at https://
www.livingdonorassistance.org.
National Living Donor Assistance
Center (NLDAC) Program Eligibility
Guidelines as Amended
Section 3 of the Organ Donation and
Recovery Improvement Act (ODRIA), 42
U.S.C. 274f, establishes the authority
and legislative parameters to provide
reimbursement for travel and
subsistence expenses incurred towards
living organ donation. HRSA awarded a
cooperative agreement to the Regents of
the University of Michigan (Michigan),
which partnered with the American
Society of Transplant Surgeons (ASTS),
to establish the National Living Donor
Assistance Center (NLDAC) to operate
this Program.
As provided for in the statutory
authorization, this Program is intended
to provide reimbursement only in those
circumstances when payment cannot
reasonably be covered by other sources
of reimbursement. The NLDAC, under
Federal law, cannot provide
reimbursement to any living organ
donor for travel and other qualifying
expenses if the donor can receive
reimbursement for these expenses from
any of the following sources:
(1) any State compensation program,
an insurance policy, or any Federal or
State health benefits program;
(2) an entity that provides health
services on a prepaid basis; or
(3) the recipient of the organ.
In response to public solicitation of
comments, a threshold of income
eligibility for the recipient of the organ
is 300 percent of the Department of
Health and Human Services (HHS)
Poverty Guidelines in effect at the time
of the eligibility determination. The
Program assumes that recipients whose
income exceeds this level will have the
ability to reimburse the living organ
VerDate Nov<24>2008
16:25 Jun 18, 2009
Jkt 217001
donor for the travel and subsistence
expenses and any other qualifying
expenses that can be authorized by the
Secretary of HHS. The Program provides
an exception to this rule for financial
hardships. A transplant social worker,
or appropriate transplant center
representative, based on a complete
recipient evaluation, can provide an
official statement, notwithstanding the
recipient’s income level, that the
recipient of the organ would face
significant financial hardship if required
to pay for the qualifying living organ
donor expenses. A recipient’s financial
hardship is defined as circumstances in
which the recipient’s income exceeds
300 percent of the HHS Poverty
Guidelines in effect at the time of the
eligibility determination, but the
individual will have difficulty paying
the donor’s expenses due to other
significant expenses. Whether or not
hardship exists in a particular case
requires a fact-specific analysis;
examples of significant expenses
include circumstances such as paying
for medical expenses not covered by
insurance or providing significant
financial support for a family member
not living in the household (e.g., elderly
parent). Waiver requests by the
transplant center, on behalf of the
donor, shall be made in writing and
shall clearly describe the circumstances
for the waiver request. The NLDAC will
review waiver requests and make a
recommendation to HRSA to either
approve or deny the request. HRSA will
make the final determination and
communicate its final determination to
the NLDAC. The NDLAC will notify the
transplant center of the final
determination. HRSA’s determination
will not be subject to appeal.
All persons who wish to become
living organ donors are eligible to
receive reimbursement for their travel
and qualified expenses if they cannot
receive reimbursement from the sources
outlined above and if all the
requirements outlined in the Criteria for
Donor Reimbursement Section are
satisfied. However, because of the
limited funds available, prospective
living donors who are most likely not
able to cover these expenses will receive
priority.
The ability to cover these expenses is
determined based on an evaluation of
(1) the donor and recipient’s income, in
relation to the HHS Poverty Guidelines
(described in Table 1.1 below), and (2)
financial hardship. As a general matter,
income refers to the donor or recipient’s
total household income. A donor may
be able to demonstrate financial
hardship, even if the donor’s income
exceeds 300 percent of the HHS Poverty
PO 00000
Frm 00056
Fmt 4703
Sfmt 4703
29219
Guidelines, if the donor will have
difficulty paying the qualifying
expenses due to other significant
expenses. Although all requests will be
reviewed on a case-by-case basis,
examples of significant expenses
include circumstances such as
providing significant financial support
for a family member not living in the
household (e.g., elderly parent), loss of
income due to donation process. Waiver
requests by the transplant center, on
behalf of the donor, shall be made in
writing and shall clearly describe the
circumstances for the waiver request.
The NLDAC will review waiver requests
and make a recommendation to HRSA
to either approve or deny the request.
HRSA will make the final determination
and communicate its final
determination to the NLDAC. The
NDLAC will notify the transplant center
of the final determination. HRSA’s
determination will not be subject to
appeal.
Donors will be given preference in the
following order of priority:
Preference Category 1: The donor’s
income and the recipient’s income are
each 300 percent or less of HHS Poverty
Guidelines in effect at the time of the
eligibility determination in their
respective states of primary residence.
Preference Category 2: Although the
donor’s income exceeds 300 percent of
the HHS Poverty Guidelines in effect in
the State of primary residence at the
time of the eligibility determination, the
donor demonstrates financial hardship.
The recipient’s income is at or below
300 percent of the HHS Poverty
Guidelines in effect in the State of
primary residence at the time of the
eligibility determination.
Preference Category 3: Any living
organ donor, regardless of income or
financial hardship, if the recipient’s
income is at or below 300 percent of the
HHS Poverty Guidelines in effect in the
recipient’s State of primary residence at
the time of the eligibility determination.
Preference Category 4: Any living
organ donor, regardless of income or
financial hardship, if the recipient (with
income above 300 percent of the HHS
Poverty Guidelines in effect in the State
of primary residence at the time of the
eligibility determination) demonstrates
financial hardship.
HRSA reserves the right for the
grantee to prioritize those most in
financial need (based on income or
other specified factors) if it receives
large numbers of applications
concerning donors meeting preference
category 1.
The HHS Poverty Guidelines for 2009
(Federal Register, Vol. 74, No. 14,
E:\FR\FM\19JNN1.SGM
19JNN1
29220
Federal Register / Vol. 74, No. 117 / Friday, June 19, 2009 / Notices
January 23, 2009, pp. 4199–4201) are
shown in the table below.
2009 HHS POVERTY GUIDELINES
Persons
in family or household
48 Contiguous
States and DC
1 ...................................................................................................................................................
2 ...................................................................................................................................................
3 ...................................................................................................................................................
4 ...................................................................................................................................................
5 ...................................................................................................................................................
6 ...................................................................................................................................................
7 ...................................................................................................................................................
8 ...................................................................................................................................................
For each additional person, add ..................................................................................................
$10,830
14,570
18,310
22,050
25,790
29,530
33,270
37,010
3,740
Alaska
Hawaii
$13,530
18,210
22,890
27,570
32,250
36,930
41,610
46,290
4,680
$12,460
16,760
21,060
25,360
29,660
33,960
38,260
42,560
4,300
Source: FEDERAL REGISTER, Vol. 74, No. 14, January 23, 2009, pp. 4199–4201.
These guidelines are updated
periodically.
Criteria for Donor Reimbursement
1. Any individual who in good faith
incurs travel and other qualifying
expenses toward the intended donation
of an organ.
2. Donor and recipient of the organ
are U.S. citizens or lawfully admitted
residents of the U.S.
3. Donor and recipient have primary
residences in the U.S. or its territories.
4. Travel is originating from the
donor’s primary residence.
5. Donor and recipient certify that
they understand and are in compliance
with Section 301 of NOTA (42 U.S.C.
274e) which states in part ‘‘* * * It
shall be unlawful for any person to
knowingly acquire, receive, or otherwise
transfer any human organ for valuable
consideration for use in human
transplantation if the transfer affects
interstate commerce.’’
6. The transplant center where the
donation procedure occurs certifies to
its status of good standing with the
Organ Procurement and Transplantation
Network (OPTN).
mstockstill on PROD1PC66 with NOTICES
Qualifying Expenses
For the purposes of the
Reimbursement of Travel and
Subsistence Expenses toward Living
Organ Donation Program, qualifying
expenses presently include only travel,
lodging, and meals and incidental
expenses incurred by the donor and/or
his/her accompanying person(s) as part
of:
(1) Donor evaluation and/or
(2) Hospitalization for the living
donor surgical procedure, and/or
(3) Medical or surgical follow-up,
clinic visits, or hospitalization within 2
calendar years following the living
donation procedure (or beyond the 2year period if exceptional circumstances
exist).
VerDate Nov<24>2008
16:25 Jun 18, 2009
Jkt 217001
The Program will pay for a total of up
to five trips; three for the donor and two
for accompanying persons. However, in
cases in which the transplant center
requests the donor to return to the
transplant center for additional visits as
a result of donor complications or other
health related issues, NLDAC may
provide reimbursement for the
additional visit(s) for the donor and an
accompanying person. The
accompanying persons need not be the
same in each trip.
The total Federal reimbursement for
qualified expenses during the donation
process for the donor and accompanying
individuals shall not exceed $6,000.00.
Reimbursement for qualifying expenses
shall be provided at the Federal perdiem rate, except for hotel
accommodation, which shall be
reimbursed at no more than 150 percent
of the Federal per diem rate.
For donor and recipient pairs
participating in a paired exchange
program, the applicable eligibility
criteria for the originally intended
recipient shall be considered for the
purpose of reimbursement of qualifying
donor expenses even though the final
recipient of the donated organ may not
be the recipient identified in the
original donor-recipient pair.
Maximum Number of Prospective
Donors per Recipient
• Kidney: one donor at a time with a
maximum of three donors
• Liver: one donor at a time with a
maximum of five donors
• Lung: two donors at a time with a
maximum of six donors
Special Provisions
Many factors may prevent the
intended and willing donor from
proceeding with the donation.
Circumstances that would prevent the
transplant or donation from proceeding
include: Present health status of the
PO 00000
Frm 00057
Fmt 4703
Sfmt 4703
intended donor or recipient, perceived
long-term risks to the intended donor,
justified circumstances such as acts of
God (e.g., major storms or hurricanes),
or a circumstance when an intended
donor proceeds toward donation in
good faith, subject to a case-by-case
evaluation by the NLDAC, but then
elects not to pursue donation. In such
cases, the intended donor and
accompanying persons may receive
reimbursement for qualified expenses
incurred as if the donation had been
completed. Under Program policy, a
form will be filed with the Internal
Revenue Service (IRS) reporting funds
disbursed as income for expenses not
incurred.
Dated: June 10, 2009.
Mary K. Wakefield,
Administrator.
[FR Doc. E9–14425 Filed 6–18–09; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HOMELAND
SECURITY
Science and Technology Directorate;
Notice of Public Meeting of the Project
25 Compliance Assessment Program
Governing Board
AGENCY: Science and Technology
Directorate, Department of Homeland
Security.
ACTION: Notice of public meeting.
SUMMARY: The U.S. Department of
Homeland Security’s (DHS) Office for
Interoperability and Compatibility (OIC)
will hold a public meeting of its Project
25 (P25) Compliance Assessment
Program (CAP) Governing Board (GB).
The P25 CAP GB is composed of public
sector officials who are involved in the
procurement of P25 equipment. The
purpose of the meeting is to collect
comments from individual P25 CAP GB
members on the proposed Compliance
E:\FR\FM\19JNN1.SGM
19JNN1
]]>Agencies
[Federal Register Volume 74, Number 117 (Friday, June 19, 2009)]
[Notices]
[Pages 29218-29220]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-14425]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Reimbursement of Travel and Subsistence Expenses toward Living
Organ Donation Eligibility Guidelines
AGENCY: Health Resources and Services Administration (HRSA), HHS.
ACTION: Response to solicitation of comments on amendment to program
follow-up period and publication of amended Program Eligibility
Guidelines.
-----------------------------------------------------------------------
SUMMARY: This notice finalizes an amendment to the eligibility
guidelines proposed on March 4, 2009 in the Federal Register (74 FR
9407). The purpose of this notice was to solicit comments on the
amendment to the Program Eligibility Guidelines proposed by HRSA
concerning the Reimbursement of Travel and Subsistence Expenses Program
follow-up period.
FOR FURTHER INFORMATION CONTACT: Richard Durbin, Director, Division of
Transplantation, Healthcare Systems Bureau, Health Resources and
Services Administration, Parklawn Building, Room 12C-06, 5600 Fishers
Lane, Rockville, Maryland 20857; telephone (301) 443-7577; fax (301)
594-6095; or E-mail: rdurbin@hrsa.gov.
SUPPLEMENTARY INFORMATION: In the existing Program eligibility
guidelines, under the Qualifying Expenses Section, the first paragraph
states:
``For the purposes of the Reimbursement of Travel and
Subsistence Expenses toward Living Organ Donation Program,
qualifying expenses presently include only travel, lodging, and
meals and incidental expenses incurred by the donor and/or his/her
accompanying person(s) as part of:
(1) Donor evaluation, clinic visit or hospitalization,
(2) Hospitalization for the living donor surgical procedure,
and/or
(3) Medical or surgical follow-up clinic visit or
hospitalization within 90 days following the living donation
procedure.''
HRSA proposed amending the first bullet of this paragraph to read:
``(1) Donor evaluation, and/or''. In addition, HRSA proposed amending
the third bullet of this paragraph to read: ``(3) Medical or surgical
follow-up clinic visit or hospitalization within two calendar years or
beyond--if exceptional circumstances exist--following the living
donation procedure.'' The purpose of this proposed change was to bring
the NLDAC follow-up period in line with the OPTN policies of a 2-year
follow-up of living organ donors.
HRSA received six public comments on this request. All the
respondents
[[Page 29219]]
support HRSA's proposed amendment. HRSA wishes to thank everyone who
reviewed this request even if a formal response was not sent to HRSA.
Through this notice, HRSA approves the amendment to the
Reimbursement of Travel and Subsistence Expenses Program Eligibility
Guidelines as published in the Federal Register. This document also
corrects a mistake included in the previous version of the Guidelines
concerning the proper decision-maker on financial hardship
determinations. Finally, HRSA notes that the grantee has the authority
to make operational decisions in implementing the Program, such as
setting filing deadlines.
The amended eligibility criteria are included in this document. The
amended eligibility criteria guidelines document is also available at
https://www.livingdonorassistance.org.
National Living Donor Assistance Center (NLDAC) Program Eligibility
Guidelines as Amended
Section 3 of the Organ Donation and Recovery Improvement Act
(ODRIA), 42 U.S.C. 274f, establishes the authority and legislative
parameters to provide reimbursement for travel and subsistence expenses
incurred towards living organ donation. HRSA awarded a cooperative
agreement to the Regents of the University of Michigan (Michigan),
which partnered with the American Society of Transplant Surgeons
(ASTS), to establish the National Living Donor Assistance Center
(NLDAC) to operate this Program.
As provided for in the statutory authorization, this Program is
intended to provide reimbursement only in those circumstances when
payment cannot reasonably be covered by other sources of reimbursement.
The NLDAC, under Federal law, cannot provide reimbursement to any
living organ donor for travel and other qualifying expenses if the
donor can receive reimbursement for these expenses from any of the
following sources:
(1) any State compensation program, an insurance policy, or any
Federal or State health benefits program;
(2) an entity that provides health services on a prepaid basis; or
(3) the recipient of the organ.
In response to public solicitation of comments, a threshold of
income eligibility for the recipient of the organ is 300 percent of the
Department of Health and Human Services (HHS) Poverty Guidelines in
effect at the time of the eligibility determination. The Program
assumes that recipients whose income exceeds this level will have the
ability to reimburse the living organ donor for the travel and
subsistence expenses and any other qualifying expenses that can be
authorized by the Secretary of HHS. The Program provides an exception
to this rule for financial hardships. A transplant social worker, or
appropriate transplant center representative, based on a complete
recipient evaluation, can provide an official statement,
notwithstanding the recipient's income level, that the recipient of the
organ would face significant financial hardship if required to pay for
the qualifying living organ donor expenses. A recipient's financial
hardship is defined as circumstances in which the recipient's income
exceeds 300 percent of the HHS Poverty Guidelines in effect at the time
of the eligibility determination, but the individual will have
difficulty paying the donor's expenses due to other significant
expenses. Whether or not hardship exists in a particular case requires
a fact-specific analysis; examples of significant expenses include
circumstances such as paying for medical expenses not covered by
insurance or providing significant financial support for a family
member not living in the household (e.g., elderly parent). Waiver
requests by the transplant center, on behalf of the donor, shall be
made in writing and shall clearly describe the circumstances for the
waiver request. The NLDAC will review waiver requests and make a
recommendation to HRSA to either approve or deny the request. HRSA will
make the final determination and communicate its final determination to
the NLDAC. The NDLAC will notify the transplant center of the final
determination. HRSA's determination will not be subject to appeal.
All persons who wish to become living organ donors are eligible to
receive reimbursement for their travel and qualified expenses if they
cannot receive reimbursement from the sources outlined above and if all
the requirements outlined in the Criteria for Donor Reimbursement
Section are satisfied. However, because of the limited funds available,
prospective living donors who are most likely not able to cover these
expenses will receive priority.
The ability to cover these expenses is determined based on an
evaluation of (1) the donor and recipient's income, in relation to the
HHS Poverty Guidelines (described in Table 1.1 below), and (2)
financial hardship. As a general matter, income refers to the donor or
recipient's total household income. A donor may be able to demonstrate
financial hardship, even if the donor's income exceeds 300 percent of
the HHS Poverty Guidelines, if the donor will have difficulty paying
the qualifying expenses due to other significant expenses. Although all
requests will be reviewed on a case-by-case basis, examples of
significant expenses include circumstances such as providing
significant financial support for a family member not living in the
household (e.g., elderly parent), loss of income due to donation
process. Waiver requests by the transplant center, on behalf of the
donor, shall be made in writing and shall clearly describe the
circumstances for the waiver request. The NLDAC will review waiver
requests and make a recommendation to HRSA to either approve or deny
the request. HRSA will make the final determination and communicate its
final determination to the NLDAC. The NDLAC will notify the transplant
center of the final determination. HRSA's determination will not be
subject to appeal.
Donors will be given preference in the following order of priority:
Preference Category 1: The donor's income and the recipient's
income are each 300 percent or less of HHS Poverty Guidelines in effect
at the time of the eligibility determination in their respective states
of primary residence.
Preference Category 2: Although the donor's income exceeds 300
percent of the HHS Poverty Guidelines in effect in the State of primary
residence at the time of the eligibility determination, the donor
demonstrates financial hardship. The recipient's income is at or below
300 percent of the HHS Poverty Guidelines in effect in the State of
primary residence at the time of the eligibility determination.
Preference Category 3: Any living organ donor, regardless of income
or financial hardship, if the recipient's income is at or below 300
percent of the HHS Poverty Guidelines in effect in the recipient's
State of primary residence at the time of the eligibility
determination.
Preference Category 4: Any living organ donor, regardless of income
or financial hardship, if the recipient (with income above 300 percent
of the HHS Poverty Guidelines in effect in the State of primary
residence at the time of the eligibility determination) demonstrates
financial hardship.
HRSA reserves the right for the grantee to prioritize those most in
financial need (based on income or other specified factors) if it
receives large numbers of applications concerning donors meeting
preference category 1.
The HHS Poverty Guidelines for 2009 (Federal Register, Vol. 74, No.
14,
[[Page 29220]]
January 23, 2009, pp. 4199-4201) are shown in the table below.
2009 HHS Poverty Guidelines
----------------------------------------------------------------------------------------------------------------
48 Contiguous
Persons in family or household States and DC Alaska Hawaii
----------------------------------------------------------------------------------------------------------------
1............................................................... $10,830 $13,530 $12,460
2............................................................... 14,570 18,210 16,760
3............................................................... 18,310 22,890 21,060
4............................................................... 22,050 27,570 25,360
5............................................................... 25,790 32,250 29,660
6............................................................... 29,530 36,930 33,960
7............................................................... 33,270 41,610 38,260
8............................................................... 37,010 46,290 42,560
For each additional person, add................................. 3,740 4,680 4,300
----------------------------------------------------------------------------------------------------------------
Source: Federal Register, Vol. 74, No. 14, January 23, 2009, pp. 4199-4201.
These guidelines are updated periodically.
Criteria for Donor Reimbursement
1. Any individual who in good faith incurs travel and other
qualifying expenses toward the intended donation of an organ.
2. Donor and recipient of the organ are U.S. citizens or lawfully
admitted residents of the U.S.
3. Donor and recipient have primary residences in the U.S. or its
territories.
4. Travel is originating from the donor's primary residence.
5. Donor and recipient certify that they understand and are in
compliance with Section 301 of NOTA (42 U.S.C. 274e) which states in
part ``* * * It shall be unlawful for any person to knowingly acquire,
receive, or otherwise transfer any human organ for valuable
consideration for use in human transplantation if the transfer affects
interstate commerce.''
6. The transplant center where the donation procedure occurs
certifies to its status of good standing with the Organ Procurement and
Transplantation Network (OPTN).
Qualifying Expenses
For the purposes of the Reimbursement of Travel and Subsistence
Expenses toward Living Organ Donation Program, qualifying expenses
presently include only travel, lodging, and meals and incidental
expenses incurred by the donor and/or his/her accompanying person(s) as
part of:
(1) Donor evaluation and/or
(2) Hospitalization for the living donor surgical procedure, and/or
(3) Medical or surgical follow-up, clinic visits, or
hospitalization within 2 calendar years following the living donation
procedure (or beyond the 2-year period if exceptional circumstances
exist).
The Program will pay for a total of up to five trips; three for the
donor and two for accompanying persons. However, in cases in which the
transplant center requests the donor to return to the transplant center
for additional visits as a result of donor complications or other
health related issues, NLDAC may provide reimbursement for the
additional visit(s) for the donor and an accompanying person. The
accompanying persons need not be the same in each trip.
The total Federal reimbursement for qualified expenses during the
donation process for the donor and accompanying individuals shall not
exceed $6,000.00. Reimbursement for qualifying expenses shall be
provided at the Federal per-diem rate, except for hotel accommodation,
which shall be reimbursed at no more than 150 percent of the Federal
per diem rate.
For donor and recipient pairs participating in a paired exchange
program, the applicable eligibility criteria for the originally
intended recipient shall be considered for the purpose of reimbursement
of qualifying donor expenses even though the final recipient of the
donated organ may not be the recipient identified in the original
donor-recipient pair.
Maximum Number of Prospective Donors per Recipient
Kidney: one donor at a time with a maximum of three donors
Liver: one donor at a time with a maximum of five donors
Lung: two donors at a time with a maximum of six donors
Special Provisions
Many factors may prevent the intended and willing donor from
proceeding with the donation. Circumstances that would prevent the
transplant or donation from proceeding include: Present health status
of the intended donor or recipient, perceived long-term risks to the
intended donor, justified circumstances such as acts of God (e.g.,
major storms or hurricanes), or a circumstance when an intended donor
proceeds toward donation in good faith, subject to a case-by-case
evaluation by the NLDAC, but then elects not to pursue donation. In
such cases, the intended donor and accompanying persons may receive
reimbursement for qualified expenses incurred as if the donation had
been completed. Under Program policy, a form will be filed with the
Internal Revenue Service (IRS) reporting funds disbursed as income for
expenses not incurred.
Dated: June 10, 2009.
Mary K. Wakefield,
Administrator.
[FR Doc. E9-14425 Filed 6-18-09; 8:45 am]
BILLING CODE 4165-15-P
