,,ii #aagth ,,congress #ast ,session ,s4 #ccja ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #b1 #bjba,mr4 ,rubio 7for himself and ,ms4 ,hassan7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to prohibit discrimination on the basis of mental or physical disability in cases of organ transplants4 #a4 ,short title ,this ,act may be cited as the ,charlotte ,woodward ,organ ,transplant ,discrimination ,prevention ,act4 #b4 ,findings ,congress finds the following3 7#a7 ,the ,americans with ,disabilities ,act of #aiij1 section #ejd of the ,rehabilitation ,act of #aigc1 and section #aeeg of the ,patient ,protection and ,affordable ,care ,act prohibit discrimination against individuals with disabilities in organ transplantation and the allocation of organs4 7#b7 ,despite those prohibitions1 there are findings and cases that show1 as is documented by the ,national ,council on ,disability and others1 that individuals with disabilities are being denied organ transplants and related services based solely on the fact that those individuals have a disability4 7#c7 ,more than #be ,states have crafted ,state-level policy to prohibit organ transplant discrimination against individuals with disabilities4 ,federal action1 however1 is required to protect individuals with disabilities and to enforce existing law regardless of the ,state in which they live4 7#d7 ,the current situation1 with continuing cases of discrimination against individuals with disabilities1 calls for further clarity by ,congress about which actions constitute discrimination under current law1 which entities are covered1 and the remedies available to individuals experiencing potential discrimination4 7#e7 ,licensed providers of health care services that provide organ transplants and related services in exchange for medical fees are engaging in an economic transaction with patients that occurs in or substantially impacts interstate commerce4 7#f7 ,there are #aa geographic regions that are used in the national administration of organ allocation in the ,united ,states1 with organs being transported across ,state lines for transplantation procedures4 7#g7 ,discrimination in organ transplantation limits individuals with disabilities from participating in health care transactions in a manner that allows equal access to interstate commerce4 7#h7 ,the existence of discrimination against individuals with disabilities in the provision of organ transplantation and related services burdens the flow of organs through legal channels of interstate commerce4 #c4 ,definitions ,in this ,act3 7#a7 ,auxiliary aids and services ,the term auxiliary aids and services includes-- 7,a7 qualified interpreters or other effective methods of making aurally delivered materials available to individuals with a hearing impairment2 7,b7 qualified readers1 taped texts1 or other effective methods of making visually delivered materials available to individuals with a visual impairment2 7,c7 information in a format that is accessible for individuals with a cognitive1 neurological1 developmental1 or intellectual disability2 7,d7 supported decisionmaking services2 and 7,e7 acquisition or modification of equipment or devices4 7#b7 ,covered entity ,the term covered entity means-- 7,a7 any licensed provider of health care services1 including licensed health care practitioners1 hospitals1 nursing facilities1 laboratories1 intermediate care facilities1 psychiatric residential treatment facilities1 institutions for individuals with intellectual or developmental disabilities1 and prison health centers1 that-- 7i7 is in interstate commerce2 or 7ii7 provides health care services in a manner that-- 7,i7 substantially affects or has a substantial relation to interstate commerce2 or 7,,ii7 includes use of an instrument 7including an instrument of transportation or communication7 of interstate commerce2 or 7,b7 any transplant center or entity responsible for matching human organ donors to potential recipients that is in interstate commerce1 or that provides the matching services in a manner described in subparagraph 7,a77ii74 7#c7 ,disability ,the term disability has the meaning given the term in section #c of the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abajb74 7#d7 ,human organ ,the term human organ has the meaning given the term in section #cja7;c7 of the ,national ,organ ,transplant ,act 7#db ,u4,s4,c4 #bgd;e7c774 7#e7 ,organ transplant ,the term organ transplant means the transplantation or transfusion of a donated human organ into the body of another human for the purpose of treating or curing a medical condition4 7#f7 ,qualified individual ,the term qualified individual means an individual who1 with or without a support network1 provision of auxiliary aids and services1 or reasonable modifications to policies or practices1 meets eligibility requirements for the receipt of a human organ4 7#g7 ,reasonable modifications to policies or practices ,the term reasonable modifications to policies or practices includes-- 7,a7 communication with individuals responsible for supporting an individual with postsurgical or other care following an organ transplant or related services1 including support with medication2 and 7,b7 consideration1 in determining whether an individual will be able to comply with health requirements following an organ transplant or receipt of related services1 of support networks available to the individual1 including family1 friends1 and providers of home and community-based services1 including home and community-based services funded through the ,medicare or ,medicaid program under title ,,xviii or ,,xix1 respectively1 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq41 #acif et seq471 another health plan in which the individual is enrolled1 or any program or source of funding available to the individual4 7#h7 ,related services ,the term related services means services related to an organ transplant that consist of-- 7,a7 evaluation2 7,b7 counseling2 7,c7 treatment1 including postoperative treatment1 and care2 7,d7 provision of information2 and 7,e7 any other service recommended or required by a physician4 7#i7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#aj7 ,supported decisionmaking ,the term supported decisionmaking means the use of a support person to assist an individual in making health care decisions1 communicate information to the individual1 or ascertain an individual's wishes4 ,such term includes-- 7,a7 the inclusion of the individual's attorney-in-fact or health care proxy1 or any person of the individual's choice1 in communications about the individual's health care2 7,b7 permitting the individual to designate a person of the individual's choice for the purposes of supporting that individual in communicating1 processing information1 or making health care decisions2 7,c7 providing auxiliary aids and services described in subparagraph 7,a71 7,b71 7,c71 or 7,e7 of paragraph 7#a7 to facilitate the individual's ability to communicate and process health-related information1 including providing use of assistive communication technology2 7,d7 providing health information to persons designated by the individual1 consistent with the regulations promulgated under section #bfd7;c7 of the ,health ,insurance ,portability and ,accountability ,act of #aiif 7#db ,u4,s4,c4 #acbj;d-#b note7 and other applicable laws and regulations governing disclosure of health information2 7,e7 providing health information in a format that is readily understandable by the individual2 and 7,f7 working with a court-appointed guardian or other individual responsible for making health care decisions on behalf of the individual1 to ensure that the individual is included in decisions involving the health care of the individual and that health care decisions are in accordance with the individual's own expressed interests4 7#aa7 ,support network ,the term support network means1 with respect to a person1 one or more individuals who are-- 7,a7 selected by the person or by the person and the guardian of the person1 to provide assistance to that person or guidance to that person in understanding issues1 making plans for the future1 or making complex decisions2 and 7,b7 who may include the family members1 friends1 unpaid supporters1 members of the religious congregation1 and appropriate personnel at a community center1 of or serving the person4 #d4 ,prohibition of discrimination 7a7 ,in general ,subject to subsection 7b71 a covered entity may not1 solely on the basis of a qualified individual's mental or physical disability-- 7#a7 determine that the individual is ineligible to receive an organ transplant or related services2 7#b7 deny the individual an organ transplant or related services2 7#c7 refuse to refer the individual to an organ transplant center or other related specialist for the purpose of receipt of an organ transplant or other related services2 7#d7 refuse to place the individual on an organ transplant waiting list1 or place the individual at a lower-priority position on the list than the position at which the individual would have been placed if not for the disability of the individual2 or 7#e7 decline insurance coverage for the individual for any procedure associated with the receipt of an organ transplant or for related services1 which procedure or services1 respectively1 would be covered under such insurance for such individual if not for the disability of the individual4 7b7 ,exception 7#a7 ,in general 7,a7 ,medically significant disabilities ,notwithstanding subsection 7a71 a covered entity may take a qualified individual's physical or mental disability into account when making a health care treatment or coverage recommendation or decision1 solely to the extent that the disability has been found by a physician1 following an individualized evaluation of the potential recipient1 to be medically significant to the receipt of the organ transplant or related services1 as the case may be4 7,b7 ,construction ,subparagraph 7,a7 shall not be construed to require a referral or recommendation for1 or the performance of1 a medically inappropriate organ transplant or medically inappropriate related services4 7#b7 ,clarification ,if a qualified individual has the necessary support network to provide a reasonable assurance that the individual will be able to comply with health requirements following an organ transplant or receipt of related services1 as the case may be1 the individual's inability to independently comply with those requirements may not be construed to be medically significant for purposes of paragraph 7#a74 7c7 ,reasonable modifications ,a covered entity shall make reasonable modifications to policies or practices 7including procedures7 of such entity if such modifications are necessary to make an organ transplant or related services available to qualified individuals with disabilities1 unless the entity can demonstrate that making such modifications would fundamentally alter the nature of such policies or practices4 7d7 ,clarifications 7#a7 ,no denial of services because of absence of auxiliary aids and services ,a covered entity shall take such steps as may be necessary to ensure that a qualified individual with a disability is not denied a procedure associated with the receipt of an organ transplant or related services1 and insurance coverage for the individual is not declined for a procedure or services described in section #d7;a77#e71 because of the absence of auxiliary aids and services1 unless the entity can demonstrate that taking such steps would fundamentally alter the nature of the procedure or services being offered or would result in an undue burden on the entity4 7#b7 ,compliance with other law ,nothing in this ,act shall be construed-- 7,a7 to prevent a covered entity from providing organ transplants or related services at a level that is greater than the level that is required by this section2 or 7,b7 to limit the rights of an individual with a disability under1 or to replace or limit the scope of obligations imposed by1 the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq47 including the provisions added to such ,act by the ,,ada ,amendments ,act of #bjjh1 section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 section #aeeg of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahaaf71 or any other applicable law4 7#c7 ,application to each part of process ,the provisions of this section apply to each part of the organ transplant process and the process for receipt of related services4 #e4 ,enforcement 7a7 ,in general ,any individual who alleges that a qualified individual was subject to a violation of section #d by a covered entity-- 7#a7 may bring a claim regarding the allegation to the ,office for ,civil ,rights of the ,department of ,health and ,human ,services1 for expedited resolution2 and 7#b7 whether or not such a claim is brought under paragraph 7#a7 or a violation is found pursuant to paragraph 7#a71 may bring a civil action in a district court of the ,united ,states for injunctive or other equitable relief1 including the relief described in subsection 7b71 against such covered entity to obtain compliance of such covered entity with such section4 7b7 ,relief available ,the injunctive and equitable relief available in a civil action brought under subsection 7a77#b71 with respect to a covered entity1 includes-- 7#a7 requiring auxiliary aids and services to be made available by such entity2 7#b7 requiring reasonable modifications to policies or practices 7including procedures7 of such entity2 or 7#c7 requiring that a facility of such entity be made readily accessible and usable4 7c7 ,expedited review ,in the case of a civil action brought under subsection 7a77#b71 with respect to a covered entity1 the district court in which such action is brought shall advance on its docket and expedite review and disposition of such action4 7d7 ,rule of construction ,nothing in this section is intended to limit or replace available remedies under the ,americans with ,disabilities ,act of #aiij or any other applicable law4 #f4 ,effect on other laws ,nothing in this ,act shall be construed to supersede any provision of any ,state or local law that provides greater rights to qualified individuals with respect to organ transplants than the rights established under this ,act4