By Ken MacLeod

GRAFTON (CBS) – President Donald Trump singed an executive order Wednesday, revamping the whole approach to treating kidney disease in this country. And a 19-year-old from Grafton is among the 30 million Americans who could benefit.

“I just try to keep busy,” said Samantha Cleveland, “so I don’t focus on why I feel so terrible.”

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Samantha still battles through chronic fatigue to ride her horse, but is well aware that thousands of people die every year waiting for a kidney.

“I try not to think about it,” she said, “because right now I’m doing OK.”

Samantha Cleveland (WBZ-TV)

But after losing one kidney at age 4, and with the other steadily failing, dialysis will be needed sooner rather than later – and Samantha is already hunting a living donor for a transplant.

“We knew this day would come,” her mother said.

Alyssa Cleveland fights back tears as she thinks about her daughter’s fragile health, and the executive order signed Wednesday by the president, which – among other things – aims to double the number of kidney transplants by the year 2030.

“My order supports the selfless individuals who donate kidneys,” proclaimed Mr. Trump.

Samantha Cleveland (WBZ-TV)

It does that by offering to repay healthy people for many costs they incur donating one of their two kidneys – things like travel, lost wages and child care.

“I’m hoping this will encourage people to reach out,” Samantha’s Mom said.

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And that would be huge.

Because of the 115,000 Americans on the organ transplant waiting list, 80 percent need a kidney. And of the 21,000 made available last year less than a third came from living donors.

“I think it’s a solid plan,” said Samantha.

Her Mom agrees. “I think it will give people more hope.”

Hope for patients like Samantha – and a giant money saver for Uncle Sam. Medicare now pays out more than $110 billion annually for kidney care – mostly on expensive dialysis for late stage renal failure.

Aggressive early treatment and many more living donor transplants would save billions.

“The goal is to find a living donor before I get to that point,” said Samantha, “so that I’m not already in the mud before I need a new kidney.”

Samantha is looking to ride horses for a long time.

“I’m sure there’s going to be some kinks along the way,” she said. “But I’m hoping it works – for everyone’s sake – and for me, as well.”

The Trump plan calls for moving the bulk of kidney dialysis away from clinics – and into the home. Much cheaper.

It also mandates stricter oversight of the 58 non-profits that collect organs for transplant – and decide where they go.

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As for Samantha, chronic fatigue has forces her to put college on hold. But she hopes that’s just temporary.

Ken MacLeod