,,ii  #aag? ,,congress  #a/ ,session    
,s4 #ccja  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #b1 #bjba,mr4 
,rubio 7= himself & ,ms4 ,hassan7       
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to prohibit discrim9ation on
 ! basis ( m5tal or physical disability 
9 cases ( organ transplants4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,*>lotte
 ,woodw>d ,organ ,transplant            
,discrim9ation ,prev5tion ,act4  #b4    
,f9d+s ,congress f9ds ! foll[+3 7#a7 ,! 
,am]icans ) ,disabilities ,act ( #aiij1 
section #ejd ( ! ,rehabilitation ,act ( 
#aigc1 & section #aeeg ( ! ,pati5t      
,protection & ,af=dable ,c>e ,act       
prohibit discrim9ation aga9/ individuals
 ) disabilities 9 organ transplantation 
& ! allocation ( organs4  7#b7 ,despite 
^? prohibitions1 !re are f9d+s & cases t
 %[1 z is docum5t$ by ! ,national       
,c\ncil on ,disability & o!rs1 t        
individuals ) disabilities are be+ d5i$ 

organ transplants & relat$ s]vices bas$ 
solely on ! fact t ^? individuals h a   
disability4  7#c7 ,m ?an #be ,/ates h   
craft$ ,/ate-level policy to prohibit   
organ transplant discrim9ation aga9/    
individuals ) disabilities4 ,f$]al      
action1 h[ev]1 is requir$ to protect    
individuals ) disabilities & to en=ce   
exi/+ law reg>dless ( ! ,/ate 9 :i* !y  
live4  7#d7 ,! curr5t situation1 )      
cont9u+ cases ( discrim9ation aga9/     
individuals ) disabilities1 calls =     
fur!r cl>ity by ,congress ab\t :i*      
actions con/itute discrim9ation "u      
curr5t law1 :i* entities are cov]$1 & ! 
rem$ies available to individuals        
exp]i5c+ pot5tial discrim9ation4  7#e7  
,lic5s$ provid]s ( heal? c>e s]vices t  
provide organ transplants & relat$      
s]vices 9 ex*ange = m$ical fees are     
engag+ 9 an economic transaction )      
pati5ts t occurs 9 or sub/antially      
impacts int]/ate comm]ce4  7#f7 ,!re are
 #aa geographic regions t are us$ 9 !   
national adm9i/ration ( organ allocation

 9 ! ,unit$ ,/ates1 ) organs be+        
transport$ across ,/ate l9es =          
transplantation proc$ures4  7#g7        
,discrim9ation 9 organ transplantation  
limits individuals ) disabilities f     
p>ticipat+ 9 heal? c>e transactions 9 a 
mann] t all[s equal access to int]/ate  
comm]ce4  7#h7 ,! exi/5ce (             
discrim9ation aga9/ individuals )       
disabilities 9 ! provision ( organ      
transplantation & relat$ s]vices burd5s 
! fl[ ( organs ?r\gh legal *annels (    
int]/ate comm]ce4  #c4 ,def9itions ,9   
?is ,act3 7#a7 ,auxili>y aids & s]vices 
,! t]m auxili>y aids & s]vices          
includes-- 7,a7 qualifi$ int]pret]s or  
o!r effective me?ods ( mak+ aurally     
deliv]$ mat]ials available to           
individuals ) a he>+ impairm5t2  7,b7   
qualifi$ read]s1 tap$ texts1 or o!r     
effective me?ods ( mak+ visually deliv]$
 mat]ials available to individuals ) a  
visual impairm5t2  7,c7 in=mation 9 a   
=mat t is accessible = individuals ) a  
cognitive1 neurological1 developm5tal1  

or intellectual disability2  7,d7       
support$ decisionmak+ s]vices2 &  7,e7  
acquisition or modification ( equipm5t  
or devices4  7#b7 ,cov]$ entity ,! t]m  
cov]$ entity means-- 7,a7 any lic5s$    
provid] ( heal? c>e s]vices1 includ+    
lic5s$ heal? c>e practition]s1          
hospitals1 nurs+ facilities1            
laboratories1 int]m$iate c>e facilities1
 psy*iatric resid5tial treatm5t         
facilities1 in/itutions = individuals ) 
intellectual or developm5tal            
disabilities1 & prison heal? c5t]s1 t-- 
7i7 is 9 int]/ate comm]ce2 or  7ii7     
provides heal? c>e s]vices 9 a mann] t--
 7,i7 sub/antially affects or has a     
sub/antial relation to int]/ate comm]ce2
 or  7,,ii7 includes use ( an in/rum5t  
7includ+ an in/rum5t ( transportation or
 communication7 ( int]/ate comm]ce2 or  
7,b7 any transplant c5t] or entity      
responsible = mat*+ human organ donors  
to pot5tial recipi5ts t is 9 int]/ate   
comm]ce1 or t provides ! mat*+ s]vices 9
 a mann] describ$ 9 subp>agraph         

7,a77ii74  7#c7 ,disability ,! t]m      
disability has ! mean+ giv5 ! t]m 9     
section #c ( ! ,am]icans ) ,disabilities
 ,act ( #aiij 7#db ,u4,s4,c4 #abajb74   
7#d7 ,human organ ,! t]m human organ has
 ! mean+ giv5 ! t]m 9 section #cja7;c7 (
 ! ,national ,organ ,transplant ,act    
7#db ,u4,s4,c4 #bgd;e7c774  7#e7 ,organ 
transplant ,! t]m organ transplant means
 ! transplantation or transfusion ( a   
donat$ human organ into ! body ( ano!r  
human = ! purpose ( treat+ or cur+ a    
m$ical condition4  7#f7 ,qualifi$       
individual ,! t]m qualifi$ individual   
means an individual :o1 ) or )\t a      
support network1 provision ( auxili>y   
aids & s]vices1 or reasonable           
modifications to policies or practices1 
meets eligibility requirem5ts = !       
receipt ( a human organ4  7#g7          
,reasonable modifications to policies or
 practices ,! t]m reasonable            
modifications to policies or practices  
includes-- 7,a7 communication )         
individuals responsible = support+ an   

individual ) po/surgical or o!r c>e     
foll[+ an organ transplant or relat$    
s]vices1 includ+ support ) m$ication2 & 
7,b7 consid]ation1 9 det]m9+ :e!r an    
individual w be able to comply ) heal?  
requirem5ts foll[+ an organ transplant  
or receipt ( relat$ s]vices1 ( support  
networks available to ! individual1     
includ+ family1 fri5ds1 & provid]s (    
home & community-bas$ s]vices1 includ+  
home & community-bas$ s]vices fund$     
?r\gh ! ,m$ic>e or ,m$icaid program "u  
title ,,xviii or ,,xix1 respectively1 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 
#acie et seq41 #acif et seq471 ano!r    
heal? plan 9 :i* ! individual is        
enroll$1 or any program or s\rce ( fund+
 available to ! individual4  7#h7       
,relat$ s]vices ,! t]m relat$ s]vices   
means s]vices relat$ to an organ        
transplant t consi/ (-- 7,a7 evaluation2
  7,b7 c\nsel+2  7,c7 treatm5t1 includ+ 
po/op]ative treatm5t1 & c>e2  7,d7      
provision ( in=mation2 &  7,e7 any o!r  
s]vice recomm5d$ or requir$ by a        

physician4  7#i7 ,secret>y ,! t]m       
,secret>y means ! ,secret>y ( ,heal? &  
,human ,s]vices4  7#aj7 ,support$       
decisionmak+ ,! t]m support$            
decisionmak+ means ! use ( a support    
p]son to assi/ an individual 9 mak+     
heal? c>e decisions1 communicate        
in=mation to ! individual1 or asc]ta9 an
 individual's wi%es4 ,su* t]m includes--
 7,a7 ! inclusion ( ! individual's      
attorney-9-fact or heal? c>e proxy1 or  
any p]son ( ! individual's *oice1 9     
communications ab\t ! individual's heal?
 c>e2  7,b7 p]mitt+ ! individual to     
designate a p]son ( ! individual's *oice
 = ! purposes ( support+ t individual 9 
communicat+1 process+ in=mation1 or mak+
 heal? c>e decisions2  7,c7 provid+     
auxili>y aids & s]vices describ$ 9      
subp>agraph 7,a71 7,b71 7,c71 or 7,e7 ( 
p>agraph 7#a7 to facilitate !           
individual's ability to communicate &   
process heal?-relat$ in=mation1 includ+ 
provid+ use ( assi/ive communication    
te*nology2  7,d7 provid+ heal? in=mation

 to p]sons designat$ by ! individual1   
consi/5t ) ! regulations promulgat$ "u  
section #bfd7;c7 ( ! ,heal? ,insurance  
,portability & ,acc\ntability ,act (    
#aiif 7#db ,u4,s4,c4 #acbj;d-#b note7 & 
o!r applicable laws & regulations gov]n+
 disclosure ( heal? in=mation2  7,e7    
provid+ heal? in=mation 9 a =mat t is   
readily und]/&able by ! individual2 &   
7,f7 work+ ) a c\rt-appo9t$ gu>dian or  
o!r individual responsible = mak+ heal? 
c>e decisions on behalf ( ! individual1 
to ensure t ! individual is includ$ 9   
decisions involv+ ! heal? c>e ( !       
individual & t heal? c>e decisions are 9
 accordance ) ! individual's own        
express$ int]e/s4  7#aa7 ,support       
network ,! t]m support network means1 ) 
respect to a p]son1 "o or m individuals 
:o are-- 7,a7 select$ by ! p]son or by !
 p]son & ! gu>dian ( ! p]son1 to provide
 assi/ance to t p]son or guidance to t  
p]son 9 und]/&+ issues1 mak+ plans = !  
future1 or mak+ complex decisions2 &    
7,b7 :o may include ! family memb]s1    

fri5ds1 unpaid support]s1 memb]s ( !    
religi\s congregation1 & appropriate    
p]sonnel at a community c5t]1 ( or s]v+ 
! p]son4  #d4 ,prohibition (            
discrim9ation  7a7 ,9 g5]al ,subject to 
subsection 7b71 a cov]$ entity may n1   
solely on ! basis ( a qualifi$          
individual's m5tal or physical          
disability-- 7#a7 det]m9e t ! individual
 is ineligible to receive an organ      
transplant or relat$ s]vices2  7#b7 d5y 
! individual an organ transplant or     
relat$ s]vices2  7#c7 refuse to ref] !  
individual to an organ transplant c5t]  
or o!r relat$ speciali/ = ! purpose (   
receipt ( an organ transplant or o!r    
relat$ s]vices2  7#d7 refuse to place ! 
individual on an organ transplant wait+ 
li/1 or place ! individual at a         
l[]-priority position on ! li/ ?an !    
position at :i* ! individual w\ld h be5 
plac$ if n = ! disability ( !           
individual2 or  7#e7 decl9e insurance   
cov]age = ! individual = any proc$ure   
associat$ ) ! receipt ( an organ        

transplant or = relat$ s]vices1 :i*     
proc$ure or s]vices1 respectively1 w\ld 
be cov]$ "u su* insurance = su*         
individual if n = ! disability ( !      
individual4  7b7 ,exception  7#a7 ,9    
g5]al  7,a7 ,m$ically significant       
disabilities ,not)/&+ subsection 7a71 a 
cov]$ entity may take a qualifi$        
individual's physical or m5tal          
disability into acc\nt :5 mak+ a heal?  
c>e treatm5t or cov]age recomm5dation or
 decision1 solely to ! ext5t t !        
disability has be5 f\nd by a physician1 
foll[+ an individualiz$ evaluation ( !  
pot5tial recipi5t1 to be m$ically       
significant to ! receipt ( ! organ      
transplant or relat$ s]vices1 z ! case  
may be4  7,b7 ,con/ruction ,subp>agraph 
7,a7 %all n be con/ru$ to require a     
ref]ral or recomm5dation =1 or !        
p]=mance (1 a m$ically inappropriate    
organ transplant or m$ically            
inappropriate relat$ s]vices4  7#b7     
,cl>ification ,if a qualifi$ individual 
has ! necess>y support network to       

provide a reasonable assurance t !      
individual w be able to comply ) heal?  
requirem5ts foll[+ an organ transplant  
or receipt ( relat$ s]vices1 z ! case   
may be1 ! individual's inability to     
indep5d5tly comply ) ^? requirem5ts may 
n be con/ru$ to be m$ically significant 
= purposes ( p>agraph 7#a74  7c7        
,reasonable modifications ,a cov]$      
entity %all make reasonable             
modifications to policies or practices  
7includ+ proc$ures7 ( su* entity if su* 
modifications are necess>y to make an   
organ transplant or relat$ s]vices      
available to qualifi$ individuals )     
disabilities1 unless ! entity c         
demon/rate t mak+ su* modifications w\ld
 fundam5tally alt] ! nature ( su*       
policies or practices4  7d7             
,cl>ifications  7#a7 ,no d5ial ( s]vices
 because ( abs5ce ( auxili>y aids &     
s]vices ,a cov]$ entity %all take su*   
/eps z may be necess>y to ensure t a    
qualifi$ individual ) a disability is n 
d5i$ a proc$ure associat$ ) ! receipt ( 

an organ transplant or relat$ s]vices1 &
 insurance cov]age = ! individual is n  
decl9$ = a proc$ure or s]vices describ$ 
9 section #d7;a77#e71 because ( ! abs5ce
 ( auxili>y aids & s]vices1 unless !    
entity c demon/rate t tak+ su* /eps w\ld
 fundam5tally alt] ! nature ( ! proc$ure
 or s]vices be+ (f]$ or w\ld result 9 an
 undue burd5 on ! entity4  7#b7         
,compliance ) o!r law ,no?+ 9 ?is ,act  
%all be con/ru$-- 7,a7 to prev5t a cov]$
 entity f provid+ organ transplants or  
relat$ s]vices at a level t is great]   
?an ! level t is requir$ by ?is section2
 or  7,b7 to limit ! rights ( an        
individual ) a disability "u1 or to     
replace or limit ! scope ( obligations  
impos$ by1 ! ,am]icans ) ,disabilities  
,act ( #aiij 7#db ,u4,s4,c4 #abaja et   
seq47 includ+ ! provisions add$ to su*  
,act by ! ,,ada ,am5dm5ts ,act ( #bjjh1 
section #ejd ( ! ,rehabilitation ,act ( 
#aigc 7#bi ,u4,s4,c4 #gid71 section     
#aeeg ( ! ,pati5t ,protection &         
,af=dable ,c>e ,act 7#db ,u4,s4,c4      

#ahaaf71 or any o!r applicable law4     
7#c7 ,application to ea* "p ( process ,!
 provisions ( ?is section apply to ea*  
"p ( ! organ transplant process & !     
process = receipt ( relat$ s]vices4  #e4
 ,en=cem5t  7a7 ,9 g5]al ,any individual
 :o alleges t a qualifi$ individual 0   
subject to a violation ( section #d by a
 cov]$ entity-- 7#a7 may br+ a claim    
reg>d+ ! allegation to ! ,(fice = ,civil
 ,rights ( ! ,dep>tm5t ( ,heal? & ,human
 ,s]vices1 = exp$it$ resolution2 &  7#b7
 :e!r or n su* a claim is br\ght "u     
p>agraph 7#a7 or a violation is f\nd    
pursuant to p>agraph 7#a71 may br+ a    
civil action 9 a di/rict c\rt ( ! ,unit$
 ,/ates = injunctive or o!r equitable   
relief1 includ+ ! relief describ$ 9     
subsection 7b71 aga9/ su* cov]$ entity  
to obta9 compliance ( su* cov]$ entity )
 su* section4  7b7 ,relief available ,! 
injunctive & equitable relief available 
9 a civil action br\ght "u subsection   
7a77#b71 ) respect to a cov]$ entity1   
includes-- 7#a7 requir+ auxili>y aids & 

s]vices to be made available by su*     
entity2  7#b7 requir+ reasonable        
modifications to policies or practices  
7includ+ proc$ures7 ( su* entity2 or    
7#c7 requir+ t a facility ( su* entity  
be made readily accessible & usable4    
7c7 ,exp$it$ review ,9 ! case ( a civil 
action br\ght "u subsection 7a77#b71 )  
respect to a cov]$ entity1 ! di/rict    
c\rt 9 :i* su* action is br\ght %all    
advance on its docket & exp$ite review &
 disposition ( su* action4  7d7 ,rule ( 
con/ruction ,no?+ 9 ?is section is      
int5d$ to limit or replace available    
rem$ies "u ! ,am]icans ) ,disabilities  
,act ( #aiij or any o!r applicable law4 
#f4 ,effect on o!r laws ,no?+ 9 ?is ,act
 %all be con/ru$ to sup]s$e any         
provision ( any ,/ate or local law t    
provides great] rights to qualifi$      
individuals ) respect to organ          
transplants ?an ! rights e/abli%$ "u ?is
 ,act4