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Organ donor funeral aid scrapped

Health department fears conflict with federal law

Friday, February 01, 2002

By Christopher Snowbeck, Post-Gazette Staff Writer

A controversial plan to help pay funeral costs for organ donors has been scrapped, and a state legislator says the state Department of Health's replacement program is an insult to donor families.

Starting last month, the new Expense Benefit Plan for Organ Donors and Their Families offers a $300 benefit per organ donor to pay for food and lodging costs incurred by a donor or the donor's family.

That's a significant change from the recommendation made by an advisory committee in 1999 to provide that sum to defray funeral expenses for a donor's family.

But the Department of Health concluded last year that the funeral benefit strayed too close to violating a federal law that prohibits offering "valuable consideration" in exchange for organs, said Steve Curovie, a deputy secretary at the Department of Health.

Department officials felt covering the costs of food and lodging was not as risky because the National Organ Transplant Act specifically allows for such reimbursements. As would have happened with the funeral benefit, the new program directs the money to the service providers, not to families or donors.

But the state legislator who first proposed the funeral benefit, Rep. William R. Robinson, D-Hill District, said donor families generally need more help paying funeral expenses than covering the costs of meals or lodging.

The idea for the funeral benefit grew partly from the heart-liver transplant of then-Gov. Robert Casey in June 1993. In that case, the donor's parents had trouble raising funds to bury their son, Robinson said.

Robinson said the law passed the following year was a way to make sure other families didn't meet that fate.

The meal-lodging benefit "is so far afield from what I was originally trying to do that it's insulting to the families who really need help," he said.

Organ recovery experts aren't thrilled with the health department's plan either, although they think the program could be helpful for living donors, who provide a minority of all organs used in transplants.

The problem with the new benefit program, they say, is that families who agree to donate organs from brain-dead relatives don't usually go to a restaurant or hotel right after making the decision.

"They say their good-byes and go home," said Brian Broznick, executive director of the Center for Organ Recovery and Education, which coordinates organ recoveries in Western Pennsylvania, West Virginia and part of New York. "We think that this [benefit is] a viable option for individuals who are living donors, but it's probably not a viable option for cadaveric donors."

The money for the benefit payments comes from the Governor Robert P. Casey Memorial Organ & Tissue Donation Awareness Trust Fund. Pennsylvanians make voluntary contributions to the trust fund through driver license and vehicle registration renewals, state income tax checkoffs and direct gifts.

The 1994 law stipulated that 10 percent of the trust fund be used for medical, funeral and incidental expenses incurred by the donor or donor's family in connection with donating an organ. The payments were not to exceed $3,000 per donor and would be made directly to the funeral home, hospital or other service provider.

The organ donation committee that advises the Department of Health on trust fund expenditures recommended in 1999 that this "funeral benefit" be voluntary and that the benefit's value be reduced to $300 so that it would not appear to be coercive.

Howard Nathan, executive director of the organ procurement organization in Eastern Pennsylvania, said the Department of Health changed the plan to a meals and lodging benefit on its own and presented it to the advisory committee as "a fait accompli." Both Nathan and Broznick are members of the advisory committee.

"The two organ procurement organizations didn't agree with this, but we basically said we're not going to stop it," Nathan said.

Broznick said the Department of Health never got a ruling from the federal government on the legality of the funeral benefit. Curovie responded that federal officials seldom respond to such requests, so health department lawyers relied on their own judgment.

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