,,ii #aah? ,,congress #b;d ,session ,s4 #djfe ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,m>* #bb1 #bjbd,mr4 ,padilla 7= himself & ,mr4 ,book]7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to prohibit discrim9ation 9 heal? c>e & require ! provision ( equitable heal? c>e1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,equal ,heal? ,c>e = ,all ,act4 #b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,9 #aiff1 ,dr4 ,m>t9 ,lu!r ,k+1 ,jr41 said ,( all ! =ms ( inequality1 inju/ice 9 heal? c>e is ! mo/ %ock+ & inhuman because x (t5 results 9 physical dea?44 7#b7 ,inequity 9 heal? c>e rema9s a p]si/5t & deva/at+ reality = _m communities1 &1 9 p>ticul>1 communities ( color4 7#c7 ,! inequitable provision ( heal? c>e has complex causes1 _m /emm+ f sy/emic inequality 9 access to heal? c>e1 h\s+1 nutrition1 economic opportunity1 education1 & o!r factors4 7#d7 ,heal? c>e outcomes = ,black communities 9 p>ticul> lag f> beh9d ^? ( ! population z a :ole4 7#e7 ,dr4 ,an?ony ,fauci1 =m] ,director ( ! ,national ,in/itute ( ,all]gy & ,infecti\s ,diseases1 said on ,april #g1 #bjbj1 ! coronavirus outbreak is %9+ a bright light on unacceptable heal? disp>ities 9 ! ,black community4 7#f7 ,a contribut+ factor 9 heal? disp>ities is explicit & implicit bias 9 ! deliv]y ( heal? c>e1 result+ 9 inf]ior c>e & poor] outcomes = "s pati5ts on ! basis ( factors t include race1 national orig91 sex 7includ+ sexual ori5tation or g5d] id5tity71 disability1 age1 & religion4 7#g7 ,! ,national ,academy ( ,m$ic9e 7=m]ly kn[n z ! ,in/itute ( ,m$ic9e7 issu$ a report 9 #bjjb titl$ ,unequal ,treatm5t1 f9d+ t racial & e?nic m9orities receive l[]-quality heal? c>e ?an ,:ites d1 ev5 :5 insurance /atus1 income1 age1 & sev]ity ( condition is comp>able4 7#h7 ,j z ,congress has s\ght to elim9ate bias1 bo? explicit & implicit1 9 employm5t1 h\s+1 & o!r p>ts ( our society1 ! elim9ation ( bias & ! legacy ( /ructural racism 9 heal? c>e is ( p>am\nt importance4 #c4 ,data collection & report+ 7a7 ,requir$ report+ 7#a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is section ref]r$ to z ! ,secret>y71 9 consultation ) ! ,director = ,civil ,rights & ,heal? ,equity1 ! ,director ( ! ,national ,in/itutes ( ,heal?1 ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices1 ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 ! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal?1 & ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 %all by regulation require all heal? c>e provid]s & facilities t are requir$ "u o!r provisions ( law to report data on specific heal? outcomes to ! ,dep>tm5t ( ,heal? & ,human ,s]vices 9 aggregate =m1 to disaggregate su* data by demographic *>act]i/ics1 includ+ by race1 national orig91 sex 7includ+ sexual ori5tation & g5d] id5tity71 disability1 & age1 z well z any o!r factor t ! ,secret>y det]m9es w\ld be useful = det]m9+ a patt]n ( inequitable provision ( heal? c>e4 7#b7 ,propos$ regulations ,n lat] ?an #ij days aft] ! date ( enactm5t ( ?is ,act1 ! ,secret>y %all issue propos$ regulations to c>ry out p>agraph 7#a74 7b7 ,repository ,! ,secret>y %all-- 7#a7 n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act1 e/abli% a repository ( ! disaggregat$ data report$ pursuant to subsection 7a72 & 7#b7 ensure t su* repository does n conta9 any data t is individually id5tifiable4 #d4 ,requir+ equitable heal? c>e 9 ! hospital value-bas$ pur*as+ program 7a7 ,equitable heal? c>e z value measurem5t ,section #ahhf7;b77#c77;,b77viii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7b77#c77;,b77viii77 is am5d$ by add+ at ! end ! foll[+ new subclause3 7,,xiii7 7aa7 ,effective = paym5ts beg9n+ ) fiscal ye> #bjbe1 9 exp&+ ! numb] ( measures "u subclause 7,,iii71 ! ,secret>y %all adopt measures t relate to equitable heal? c>e furni%$ by hospitals 9 inpati5t sett+s4 7bb7 ,9 c>ry+ out ?is subclause1 ! ,secret>y %all solicit input & recomm5dations f individuals & gr\ps repres5t+ communities ( color & o!r protect$ classes & ensure measures adopt$ pursuant to ?is subclause acc\nt = social det]m9ants ( heal?1 z def9$ 9 section #g7;e77#aj7 ( ! ,equal ,heal? ,c>e = ,all ,act1 su* t ! social det]m9ants ( heal? d n adv]sely affect hospitals if ! inequitable outcomes are n caus$ by t hospital's provision ( c>e4 7cc7 ,= purposes ( ?is subclause1 ! t]m equitable heal? c>e ref]s to ! pr9ciple t high-quality c>e %\ld be provid$ to all individuals & heal? c>e treatm5t & s]vices %\ld n v>y on acc\nt ( ! real or p]ceiv$ race1 national orig91 sex 7includ+ sexual ori5tation & g5d] id5tity71 disability1 or age ( an individual1 z well z any o!r factor t ! ,secret>y det]m9es w\ld be useful = det]m9+ a patt]n ( inequitable provision ( heal? c>e4 4 7b7 ,inclusion ( equitable heal? c>e measures ,section #ahhf7o77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7o77#b77;,b77 is am5d$ by add+ at ! end ! foll[+ new clause3 7iv7 ,inclusion ( equitable heal? c>e measures ,beg9n+ 9 fiscal ye> #bjbe1 measures select$ "u subp>agraph 7,a7 %all include ! equitable heal? c>e measures describ$ 9 subsection 7b77#c77;,b77viii77,,xiii74 4 #e4 ,inequitable provision ( heal? c>e z a basis = p]missive exclusion f ,m$ic>e & o!r ,f$]al heal? c>e programs ,section #aabh7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g7;b77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#ah7 ,inequitable provision ( heal? c>e 7,a7 ,9 g5]al ,subject to subp>agraph 7,b71 any heal? c>e provid] t ! ,secret>y det]m9es1 "u section #g7;b77#b7 ( ! ,equal ,heal? ,c>e = ,all ,act1 has engag$ 9 a patt]n ( inequitable provision ( heal? c>e 7z def9$ 9 subsection 7e77#g7 ( t ,act7 on ! basis ( race1 national orig91 sex 7includ+ sexual ori5tation & g5d] id5tity71 disability1 or age ( an individual4 7,b7 ,exception ,= purposes ( c>ry+ out subp>agraph 7,a71 ! ,secret>y %all n exclude any heal? c>e provid] f p>ticipation 9 ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act or ! ,m$icaid program "u title ,,xix ( su* ,act if ! exclusion ( su* heal? c>e provid] w\ld result 9 increas$ difficulty 9 access to heal? c>e s]vices = und]s]v$ or l[-income communities4 4 #f4 ,(fice = ,civil ,rights & ,heal? ,equity ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices 7a7 ,"n ( (fice ,beg9n+ on ! date ( enactm5t ( ?is ,act1 ! ,(fice = ,civil ,rights ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices %all be kn[n z ! ,(fice = ,civil ,rights & ,heal? ,equity ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 ,any ref]5ce to ! ,(fice = ,civil ,rights ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices 9 any law1 regulation1 map1 docum5t1 record1 or o!r pap] ( ! ,unit$ ,/ates %all be deem$ to be a ref]5ce to ! ,(fice = ,civil ,rights & ,heal? ,equity4 7b7 ,head ( (fice ,! head ( ! ,(fice = ,civil ,rights & ,heal? ,equity %all be ! ,director = ,civil ,rights & ,heal? ,equity1 to be appo9t$ by ! ,presid5t4 ,any ref]5ce to ! ,director ( ! ,(fice = ,civil ,rights ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices 9 any law1 regulation1 map1 docum5t1 record1 or o!r pap] ( ! ,unit$ ,/ates %all be deem$ to be a ref]5ce to ! ,director = ,civil ,rights & ,heal? ,equity4 #g4 ,prohibit+ discrim9ation 9 heal? c>e 7a7 ,prohibit+ discrim9ation 7#a7 ,9 g5]al ,no heal? c>e provid] may1 on ! basis1 9 :ole or 9 "p1 ( race1 sex 7includ+ sexual ori5tation & g5d] id5tity71 disability1 age1 or religion1 subject an individual to ! inequitable provision ( heal? c>e4 7#b7 ,notice ( pati5t rights ,! ,secret>y %all provide to ea* pati5t a notice ( a pati5t's rights "u ?is section4 7b7 ,adm9i/rative compla9t & conciliation process 7#a7 ,compla9ts & answ]s 7,a7 ,9 g5]al ,an aggriev$ p]son may1 n lat] ?an #a ye> aft] an alleg$ violation ( subsection 7a7 has occurr$ or conclud$1 file a compla9t ) ! ,director alleg+ inequitable provision ( heal? c>e by a provid] describ$ 9 subsection 7a74 7,b7 ,compla9t ,a compla9t submitt$ pursuant to subp>agraph 7,a7 %all be 9 writ+ & %all conta9 su* in=mation & be 9 su* =m z ! ,director requires4 7,c7 ,oa? or affirmation ,! compla9t & any answ] made "u ?is subsection %all be made "u oa? or affirmation1 & may be reasonably & fairly modifi$ at any "t4 7#b7 ,response to compla9ts 7,a7 ,9 g5]al ,^u ! fil+ ( a compla9t "u ?is subsection1 ! foll[+ proc$ures %all apply3 7i7 ,compla9ant notice ,! ,director %all s]ve notice ^u ! compla9ant ackn[l$g+ receipt ( su* fil+ & advis+ ! compla9ant ( ! "t limits & proc$ures provid$ "u ?is section4 7ii7 ,respond5t notice ,! ,director %all1 n lat] ?an #cj days aft] receipt ( su* fil+-- 7,i7 s]ve on ! respond5t a notice ( ! compla9t1 toge!r ) a copy ( ! orig9al compla9t2 & 7,,ii7 advise ! respond5t ( ! proc$ural rights & obligations ( respond5ts "u ?is section4 7iii7 ,answ] ,! respond5t may file1 n lat] ?an #fj days aft] receipt ( ! notice f ! ,director1 an answ] to su* compla9t4 7iv7 ,inve/igative duties ,! ,director %all-- 7,i7 make an inve/igation ( ! alleg$ inequitable provision ( heal? c>e2 & 7,,ii7 complete su* inve/igation )9 #ahj days 7unless x is impracticable to complete su* inve/igation )9 #ahj days7 aft] ! fil+ ( ! compla9t4 7,b7 ,inve/igations 7i7 ,patt]n or practice ,9 ! c\rse ( inve/igat+ ! compla9t1 ! ,director may seek records ( c>e provid$ to pati5ts o!r ?an ! compla9ant if necess>y to demon/rate or disprove an allegation ( inequitable provision ( heal? c>e or to det]m9e :e!r !re is a patt]n or practice ( su* c>e4 7ii7 ,acc\nt+ = social det]m9ants ( heal? ,9 inve/igat+ ! compla9t & rea*+ a det]m9ation on ! validity ( ! compla9t1 ! ,director %all acc\nt = social det]m9ants ( heal? & ! effect ( su* social det]m9ants on heal? c>e outcomes1 s t ! heal? c>e provid] nam$ 9 ! compla9t is n held acc\ntable = a factor outside ( ! control ( ! provid]'s provision ( heal? c>e4 7iii7 ,inability to complete inve/igation ,if ! ,director is unable to complete 7or f9ds x is impracticable to complete7 ! inve/igation )9 #ahj days aft] ! fil+ ( ! compla9t 7or1 if ! ,secret>y takes fur!r action "u p>agraph 7#f77;,b7 ) respect to a compla9t1 )9 #ahj days aft] ! comm5cem5t ( su* fur!r action71 ! ,director %all notify ! compla9ant & respond5t 9 writ+ ( ! reasons involv$4 7iv7 ,report to /ate lic5s+ au?orities ,on conclud+ ea* inve/igation "u ?is subp>agraph1 ! ,director %all provide to ea* ,/ate lic5s+ au?ority t is responsible = ! lic5s+ ( ! heal? c>e provid] "u inve/igation1 in=mation specify+ ! results ( ! inve/igation4 7,c7 ,report 7i7 ,f9al report ,on complet+ ea* inve/igation "u ?is p>agraph1 ! ,director %all prep>e a f9al inve/igative report4 7ii7 ,modification ( report ,a f9al report "u ?is subp>agraph may be modifi$ if additional evid5ce is lat] discov]$4 7#c7 ,conciliation 7,a7 ,9 g5]al ,dur+ ! p]iod beg9n+ on ! date on :i* a compla9t is fil$ "u ?is subsection & end+ on ! date ( f9al disposition ( su* compla9t 7includ+ dur+ an inve/igation "u p>agraph 7#b77;,b771 ! ,director %all1 to ! ext5t feasible1 engage 9 conciliation ) respect to su* compla9t4 7,b7 ,conciliation agreem5t ,a conciliation agreem5t aris+ out ( su* conciliation %all be an agreem5t betwe5 ! respond5t & ! compla9ant1 & %all be subject to approval by ! ,director4 7,c7 ,rights protect$ ,! ,director %all approve a conciliation agreem5t only if ! agreem5t protects ! rights ( ! compla9ant & o!r p]sons simil>ly situat$4 7,d7 ,report+ ( agreem5t 7i7 ,9 g5]al ,subject to clause 7ii71 ! ,secret>y %all make available to ! ,/ate lic5s+ au?ority describ$ 9 p>agraph 7#b77;,b77iv7 a copy ( a conciliation agreem5t ent]$ into pursuant to ?is subsection unless ! compla9ant & respond5t o!rwise agree1 & ! ,secret>y det]m9es1 t disclosure is n requir$ to fur!r ! purposes ( ?is subsection4 7ii7 ,limitation ,a conciliation agreem5t t is made available to ! ,/ate lic5s+ au?ority pursuant to clause 7i7 may n disclose individually id5tifiable heal? in=mation4 7#d7 ,failure to comply ) conciliation agreem5t ,:5ev] ! ,director has reasonable cause to believe t a respond5t has brea*$ a conciliation agreem5t1 ! ,director %all ref] ! matt] to ! ,attorney ,g5]al to consid] fil+ a civil action to en=ce su* agreem5t4 7#e7 ,writt5 cons5t = disclosure ( in=mation ,no?+ said or done 9 ! c\rse ( conciliation "u ?is subsection may be made public1 or us$ z evid5ce 9 a subsequ5t proce$+ "u ?is subsection1 )\t ! writt5 cons5t ( ! p>ties to ! conciliation4 7#f7 ,prompt judicial action 7,a7 ,9 g5]al ,if ! ,director det]m9es at any "t foll[+ ! fil+ ( a compla9t "u ?is subsection t prompt judicial action is necess>y to c>ry out ! purposes ( ?is subsection1 ! ,director may recomm5d t ! ,attorney ,g5]al promptly comm5ce a civil action "u subsection 7d74 7,b7 ,imm$iate suit ,if ! ,director det]m9es at any "t foll[+ ! fil+ ( a compla9t "u ?is subsection t ! public int]e/ w\ld be s]v$ by all[+ ! compla9ant to br+ a civil action "u subsection 7c7 9 a ,/ate or ,f$]al c\rt imm$iately1 ! ,director %all c]tify t ! adm9i/rative process has conclud$ & t ! compla9ant may file su* a suit imm$iately4 7#g7 ,annual report ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act1 & annually !reaft]1 ! ,director %all make publicly available a report detail+ ! activities ( ! ,(fice = ,civil ,rights & ,heal? ,equity "u ?is subsection1 includ+-- 7,a7 ! numb] ( compla9ts fil$ & ! basis on :i* ! compla9ts 7 fil$2 7,b7 ! numb] ( inve/igations und]tak5 z a result ( su* compla9ts2 & 7,c7 ! disposition ( all su* inve/igations4 7c7 ,en=cem5t by private p]sons 7#a7 ,9 g5]al 7,a7 ,civil action 7i7 ,9 suit ,a compla9ant "u subsection 7b7 may comm5ce a civil action to obta9 appropriate relief ) respect to an alleg$ violation ( subsection 7a71 or = brea* ( a conciliation agreem5t "u subsection 7b71 9 an appropriate di/rict c\rt ( ! ,unit$ ,/ates or ,/ate c\rt-- 7,i7 n soon] ?an ! e>lie/ (-- 7aa7 ! date a conciliation agreem5t is rea*$ "u subsection 7b72 7bb7 ! date ( a f9al disposition ( a compla9t "u subsection 7b72 or 7cc7 #ahj days aft] ! fir/ day ( ! alleg$ violation2 & 7,,ii7 n lat] ?an #b ye>s aft] ! f9al day ( ! alleg$ violation4 7ii7 ,/atute ( limitations ,! computation ( su* #b-ye> p]iod %all n include any "t dur+ :i* an adm9i/rative proce$+ 7includ+ inve/igation or conciliation7 "u subsection 7b7 0 p5d+ ) respect to a compla9t "u su* subsection4 7,b7 ,b>r+ suit ,if ! ,director has obta9$ a conciliation agreem5t "u subsection 7b7 reg>d+ an alleg$ violation ( subsection 7a71 no action may be fil$ "u ?is p>agraph by ! compla9ant involv$ ) respect to ! alleg$ violation except = ! purpose ( en=c+ ! t]ms ( su* an agreem5t4 7#b7 ,relief :i* may be grant$ 7,a7 ,9 g5]al ,9 a civil action "u p>agraph 7#a71 if ! c\rt f9ds t a violation ( subsection 7a7 or brea* ( a conciliation agreem5t has occurr$1 ! c\rt may aw>d to ! pla9tiff actual & punitive damages1 & may grant z relief1 z ! c\rt det]m9es to be appropriate1 any p]man5t or tempor>y injunction1 tempor>y re/ra9+ ord]1 or o!r ord] 7includ+ an ord] enjo9+ ! def5dant f engag+ 9 a practice violat+ subsection 7a7 or ord]+ su* affirmative action z may be appropriate74 7,b7 ,fees & co/s ,9 a civil action "u p>agraph 7#a71 ! c\rt1 9 its discretion1 may all[ ! prevail+ p>ty1 o!r ?an ! ,unit$ ,/ates1 a reasonable attorney's fee & co/s4 ,! ,unit$ ,/ates %all be liable = su* fees & co/s to ! same ext5t z a private p]son4 7#c7 ,int]v5tion by ,attorney ,g5]al ,^u timely application1 ! ,attorney ,g5]al may int]v5e 9 a civil action "u p>agraph 7#a71 if ! ,attorney ,g5]al c]tifies t ! case is ( g5]al public importance4 7d7 ,en=cem5t by ! ,attorney ,g5]al 7#a7 ,comm5cem5t ( actions 7,a7 ,patt]n or practice cases ,! ,attorney ,g5]al may comm5ce a civil action 9 any appropriate di/rict c\rt ( ! ,unit$ ,/ates if ! ,attorney ,g5]al has reasonable cause to believe t any heal? c>e provid] cov]$ by subsection 7a7-- 7i7 is engag$ 9 a patt]n or practice t violates su* subsection2 or 7ii7 is engag$ 9 a violation ( su* subsection t raises an issue ( significant public importance4 7,b7 ,cases by ref]ral ,! ,director may det]m9e1 bas$ on a patt]n ( compla9ts1 a patt]n ( violations1 a review ( data report$ by a heal? c>e provid] cov]$ by subsection 7a71 or any o!r means1 t !re is reasonable cause to believe a heal? c>e provid] is engag$ 9 a patt]n or practice t violates subsection 7a74 ,if ! ,director makes su* a det]m9ation1 ! ,director %all ref] ! relat$ f9d+s to ! ,attorney ,g5]al4 ,if ! ,attorney ,g5]al f9ds t su* reasonable cause exi/s1 ! ,attorney ,g5]al may comm5ce a civil action 9 any appropriate di/rict c\rt ( ! ,unit$ ,/ates4 7#b7 ,en=cem5t ( subpo5as ,! ,attorney ,g5]al1 on behalf ( ! ,director1 or ano!r p>ty at ^: reque/ a subpo5a is issu$ "u ?is subsection1 may en=ce su* subpo5a 9 appropriate proce$+s 9 ! di/rict c\rt ( ! ,unit$ ,/ates = ! di/rict 9 :i* ! p]son to :om ! subpo5a 0 address$ resides1 0 s]v$1 or transacts bus9ess4 7#c7 ,relief :i* may be grant$ 9 civil actions 7,a7 ,9 g5]al ,9 a civil action "u p>agraph 7#a71 ! c\rt-- 7i7 may aw>d su* prev5tive relief1 includ+ a p]man5t or tempor>y injunction1 tempor>y re/ra9+ ord]1 or o!r ord] aga9/ ! p]son responsible = a violation ( subsection 7a7 z is necess>y to assure ! full enjoym5t ( ! rights grant$ by ?is subsection2 7ii7 may aw>d su* o!r relief z ! c\rt det]m9es to be appropriate1 includ+ monet>y damages1 to aggriev$ p]sons2 & 7iii7 may1 to v9dicate ! public int]e/1 assess punitive damages aga9/ ! respond5t-- 7,i7 9 an am\nt n exce$+ #ejj1jjj1 = a fir/ violation2 & 7,,ii7 9 an am\nt n exce$+ #a1jjj1jjj1 = any subsequ5t violation4 7,b7 ,fees & co/s ,9 a civil action "u ?is subsection1 ! c\rt1 9 its discretion1 may all[ ! prevail+ p>ty1 o!r ?an ! ,unit$ ,/ates1 a reasonable attorney's fee & co/s4 ,! ,unit$ ,/ates %all be liable = su* fees & co/s to ! ext5t provid$ by section #bdab ( title #bh1 ,unit$ ,/ates ,code4 7#d7 ,int]v5tion 9 civil actions ,^u timely application1 any p]son may int]v5e 9 a civil action comm5c$ by ! ,attorney ,g5]al "u p>agraphs 7#a7 & 7#b7 if ! action involves an alleg$ violation ( subsection 7a7 ) respect to :i* su* p]son is an aggriev$ p]son 7includ+ a p]son :o is a compla9ant "u subsection 7b77 or a conciliation agreem5t to :i* su* p]son is a p>ty4 7e7 ,def9itions ,9 ?is section3 7#a7 ,aggriev$ p]son ,! t]m aggriev$ p]son means-- 7,a7 a p]son :o believes t ! p]son 0 or w be injur$ 9 violation ( subsection 7a72 or 7,b7 ! p]sonal repres5tative or e/ate ( a deceas$ p]son :o 0 injur$ 9 violation ( subsection 7a74 7#b7 ,director ,! t]m ,director means ! ,director = ,civil ,rights & ,heal? ,equity ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7#c7 ,disability ,! t]m disability has ! mean+ giv5 su* t]m 9 section #c ( ! ,am]icans ) ,disabilities ,act ( #aiij 7#db ,u4,s4,c4 #abajb74 7#d7 ,conciliation ,! t]m conciliation means ! attempt$ resolution ( issues rais$ by a compla9t1 or by ! inve/igation ( su* compla9t1 ?r\gh in=mal negotiations involv+ ! compla9ant1 ! respond5t1 & ! ,secret>y4 7#e7 ,conciliation agreem5t ,! t]m conciliation agreem5t means a writt5 agreem5t sett+ =? ! resolution ( ! issues 9 conciliation4 7#f7 ,individually id5tifiable heal? in=mation ,! t]m individually id5tifiable heal? in=mation means any in=mation1 includ+ demographic in=mation collect$ f an individual-- 7,a7 t is creat$ or receiv$ by a heal? c>e provid] cov]$ by subsection 7a71 heal? plan1 employ]1 or heal? c>e cle>+h\se2 7,b7 t relates to ! pa/1 pres5t1 or future physical or m5tal heal? or condition (1 ! provision ( heal? c>e to1 or ! pa/1 pres5t1 or future paym5t = ! provision ( heal? c>e to1 ! individual2 & 7,c7 7i7 t id5tifies ! individual2 or 7ii7 ) respect to :i* !re is a reasonable basis to believe t ! in=mation c be us$ to id5tify ! individual4 7#g7 ,inequitable provision ( heal? c>e ,! t]m inequitable provision ( heal? c>e means ! provision ( any heal? c>e s]vice1 by a heal? c>e provid] 9 a mann] t-- 7,a7 fails to meet a high-quality c>e /&>d1 mean+ ! heal? c>e provid] fails to-- 7i7 avoid h>m to pati5ts z a result ( ! heal? s]vices t are int5d$ to help ! pati5t2 7ii7 provide heal? s]vices bas$ on sci5tific k to all & to all pati5ts :o b5efit2 7iii7 refra9 f provid+ s]vices to pati5ts n likely to b5efit2 7iv7 provide c>e t is responsive to pati5t pref]5ces1 ne$s1 & values2 & 7v7 avoids waits or delays 9 c>e2 & 7,b7 is discrim9atory 9 int5t or effect bas$ at lea/ 9 "p on a basis specifi$ 9 subsection 7a74 7#h7 ,respond5t ,! t]m respond5t means ! p]son or o!r entity accus$ 9 a compla9t ( a violation ( subsection 7a74 7#i7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,heal? & ,human ,s]vices4 7#aj7 ,social det]m9ants ( heal? ,! t]m social det]m9ants ( heal? means conditions 9 ! environm5ts 9 :i* individuals live1 "w1 att5d s*ool1 & wor%ip1 t affect a wide range ( heal?1 function+1 & quality-(-life outcomes & risks4 7f7 ,rule ( con/ruction ,no?+ 9 ?is section %all be con/ru$ z repeal+ or limit+ ! effect ( title ,,vi ( ! ,civil ,rights ,act ( #aifd 7#db ,u4,s4,c4 #bjjj;d et seq471 section #aeeg ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahaaf71 section #ejd ( ! ,rehabilitation ,act ( #aigc 7#bi ,u4,s4,c4 #gid71 or ! ,age ,discrim9ation ,act ( #aige 7#db ,u4,s4,c4 #faja et seq474 #h4 ,f$]al ,heal? ,equity ,commission 7a7 ,e/abli%m5t ( ,commission 7#a7 ,9 g5]al ,!re is e/abli%$ ! ,f$]al ,heal? ,equity ,commission 79 ?is section ref]r$ to z ! ,commission74 7#b7 ,memb]%ip 7,a7 ,9 g5]al ,! ,commission %all be compos$ (-- 7i7 #h vot+ memb]s appo9t$ "u subp>agraph 7,b72 & 7ii7 ! nonvot+1 ex (ficio memb]s describ$ 9 subp>agraph 7,c74 7,b7 ,vot+ memb]s ,n m ?an #d ( ! memb]s describ$ 9 subp>agraph 7,a77i7 %all at any "o "t be ( ! same political p>ty4 ,su* memb]s %all h recogniz$ exp]tise 9 & p]sonal exp]i5ce ) racial & e?nic heal? inequities1 heal? c>e ne$s ( vuln]able & m>g9aliz$ populations1 & heal? equity z a vehicle = improv+ heal? /atus & heal? outcomes4 ,su* memb]s %all be appo9t$ to ! ,commission z foll[s3 7i7 #d memb]s ( ! ,commission %all be appo9t$ by ! ,presid5t4 7ii7 #b memb]s ( ! ,commission %all be appo9t$ by ! ,presid5t pro tempore ( ! ,s5ate1 ^u ! recomm5dations ( ! majority lead] & ! m9ority lead] ( ! ,s5ate4 ,ea* memb] appo9t$ to ! ,commission "u ?is clause %all be appo9t$ f a diff]5t political p>ty4 7iii7 #b memb]s ( ! ,commission %all be appo9t$ by ! ,speak] ( ! ,h\se ( ,repres5tatives ^u ! recomm5dations ( ! majority lead] & ! m9ority lead] ( ! ,h\se ( ,repres5tatives4 ,ea* memb] appo9t$ to ! ,commission "u ?is clause %all be appo9t$ f a diff]5t political p>ty4 7,c7 ,ex (ficio memb] ,! ,commission %all h ! foll[+ nonvot+1 ex (ficio memb]s3 7i7 ,! ,director = ,civil ,rights & ,heal? ,equity ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7ii7 ,! ,deputy ,assi/ant ,secret>y = ,m9ority ,heal? ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7iii7 ,! ,director ( ! ,national ,in/itute on ,m9ority ,heal? & ,heal? ,disp>ities4 7iv7 ,! ,*airp]son ( ! ,advisory ,committee on ,m9ority ,heal? e/abli%$ "u section #agjg7;c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjju-#f7;c774 7#c7 ,t]ms ,! t]m ( (fice ( ea* memb] ( ! ,commission appo9t$ "u p>agraph 7#b77;,b7 %all be #f ye>s4 7#d7 ,*airp]son2 ,vice ,*airp]son 7,a7 ,*airp]son ,! ,presid5t %all1 ) ! concurr5ce ( a majority ( ! memb]s ( ! ,commission appo9t$ "u p>agraph 7#b77;,b71 designate a ,*airp]son f among ! memb]s ( ! ,commission appo9t$ "u su* p>agraph4 7,b7 ,vice ,*airp]son 7i7 ,designation ,! ,speak] ( ! ,h\se ( ,repres5tatives %all1 9 consultation ) ! majority lead]s & ! m9ority lead]s ( ! ,s5ate & ! ,h\se ( ,repres5tatives & ) ! concurr5ce ( a majority ( ! memb]s ( ! ,commission appo9t$ "u p>agraph 7#b77;,b71 designate a ,vice ,*airp]son f among ! memb]s ( ! ,commission appo9t$ "u su* p>agraph4 ,! ,vice ,*airp]son may n be a memb] ( ! same political p>ty z ! ,*airp]son4 7ii7 ,duty ,! ,vice ,*airp]son %all act 9 place ( ! ,*airp]son 9 ! abs5ce ( ! ,*airp]son4 7#e7 ,removal ( memb]s ,! ,presid5t may remove a memb] ( ! ,commission only = neglect ( duty or malfeasance 9 (fice4 7#f7 ,quorum ,a majority ( memb]s ( ! ,commission appo9t$ "u p>agraph 7#b77;,b7 %all con/itute a quorum ( ! ,commission1 b a less] numb] ( memb]s may hold he>+s4 7b7 ,duties ( ! ,commission 7#a7 ,9 g5]al ,! ,commission %all-- 7,a7 monitor & report on ! implem5tation ( ?is ,act2 & 7,b7 inve/igate1 monitor1 & report on progress t[>ds heal? equity & ! elim9ation ( heal? disp>ities4 7#b7 ,annual report ,! ,commission %all-- 7,a7 submit to ! ,presid5t & ,congress at lea/ "o report annually on heal? equity & heal? disp>ities2 & 7,b7 include 9 su* report-- 7i7 a description ( actions tak5 by ! ,dep>tm5t ( ,heal? & ,human ,s]vices & any o!r ,f$]al ag5cy relat$ to heal? equity or heal? disp>ities2 & 7ii7 recomm5dations on ensur+ equitable heal? c>e & elim9at+ heal? disp>ities4 7c7 ,p[]s 7#a7 ,he>+s 7,a7 ,9 g5]al ,! ,commission or1 at ! direction ( ! ,commission1 any subcommittee or memb] ( ! ,commission1 may1 = ! purpose ( c>ry+ out ?is section1 z ! ,commission or ! subcommittee or memb] consid]s advisable-- 7i7 hold su* he>+s1 meet & act at su* times & places1 take su* te/imony1 receive su* evid5ce1 & adm9i/] su* oa?s2 & 7ii7 require1 by subpo5a or o!rwise1 ! att5dance & te/imony ( su* witnesses & ! production ( su* books1 records1 correspond5ce1 memor&a1 pap]s1 docum5ts1 tapes1 & mat]ials4 7,b7 ,limitation on he>+s ,! ,commission may hold a he>+ "u subp>agraph 7,a77i7 only if ! he>+ is approv$-- 7i7 by a majority ( ! memb]s ( ! ,commission appo9t$ "u subsection 7a77#b77;,b72 or 7ii7 by a majority ( su* memb]s pres5t at a meet+ :5 a quorum is pres5t4 7#b7 ,issuance & en=cem5t ( subpo5as 7,a7 ,issuance ,a subpo5a issu$ "u p>agraph 7#a7 %all-- 7i7 be> ! signature ( ! ,*airp]son ( ! ,commission2 & 7ii7 be s]v$ by any p]son or class ( p]sons designat$ by ! ,*airp]son = t purpose4 7,b7 ,en=cem5t ,9 ! case ( contumacy or failure to obey a subpo5a issu$ "u p>agraph 7#a71 ! ,unit$ ,/ates di/rict c\rt = ! di/rict 9 :i* ! subpo5a$ p]son resides1 is s]v$1 or may be f\nd may issue an ord] requir+ ! p]son to appe> at any designat$ place to te/ify or to produce docum5t>y or o!r evid5ce4 7,c7 ,noncompliance ,any failure to obey ! ord] ( ! c\rt may be puni%$ by ! c\rt z a contempt ( c\rt4 7#c7 ,witness all[ances & fees 7,a7 ,9 g5]al ,section #ahba ( title #bh1 ,unit$ ,/ates ,code1 %all apply to a witness reque/$ or subpo5a$ to appe> at a he>+ ( ! ,commission4 7,b7 ,exp5ses ,! p] diem & mileage all[ances = a witness %all be paid f funds available to pay ! exp5ses ( ! ,commission4 7#d7 ,po/al s]vices ,! ,commission may use ! ,unit$ ,/ates mails 9 ! same mann] & "u ! same conditions z o!r ag5cies ( ! ,f$]al ,gov]nm5t4 7#e7 ,gifts ,! ,commission may accept1 use1 & dispose ( gifts or donations ( s]vices or prop]ty4 7d7 ,adm9i/rative ,provisions 7#a7 ,/aff 7,a7 ,director ,!re %all be a full-"t /aff director = ! ,commission :o %all-- 7i7 s]ve z ! adm9i/rative head ( ! ,commission2 & 7ii7 be appo9t$ by ! ,*airp]son ) ! concurr5ce ( ! ,vice ,*airp]son4 7,b7 ,o!r p]sonnel ,! ,commission may-- 7i7 appo9t su* o!r p]sonnel z x consid]s advisable1 subject to ! provisions ( title #e1 ,unit$ ,/ates ,code1 gov]n+ appo9tm5ts 9 ! competitive s]vice1 & ! provisions ( *apt] #ea & sub*apt] ,,iii ( *apt] #ec ( t title relat+ to classification & ,g5]al ,s*$ule pay rates2 & 7ii7 may procure tempor>y & int]mitt5t s]vices "u section #caji7;b7 ( title #e1 ,unit$ ,/ates ,code1 at rates = individuals n 9 excess ( ! daily equival5t paid = positions at ! maximum rate = ,,gs-#ae ( ! ,g5]al ,s*$ule "u section #eccb ( title #e1 ,unit$ ,/ates ,code4 7#b7 ,comp5sation ( memb]s 7,a7 ,non-,f$]al employees ,ea* memb] ( ! ,commission :o is n an (fic] or employee ( ! ,f$]al ,gov]nm5t %all be comp5sat$ at a rate equal to ! daily equival5t ( ! annual rate ( basic pay prescrib$ = level ,,iv ( ! ,executive ,s*$ule "u section #ecae ( title #e1 ,unit$ ,/ates ,code1 = ea* day 7includ+ travel "t7 dur+ :i* ! memb] is engag$ 9 ! p]=mance ( ! duties ( ! ,commission4 7,b7 ,f$]al employees ,ea* memb] ( ! ,commission :o is an (fic] or employee ( ! ,f$]al ,gov]nm5t %all s]ve )\t comp5sation 9 addition to ! comp5sation receiv$ = ! s]vices ( ! memb] z an (fice or employee ( ! ,f$]al ,gov]nm5t4 7,c7 ,travel exp5ses ,a memb] ( ! ,commission %all be all[$ travel exp5ses1 includ+ p] diem 9 lieu ( subsi/5ce1 at rates au?oriz$ = an employee ( an ag5cy "u sub*apt] ,i ( *apt] #eg ( title #e1 ,unit$ ,/ates ,code1 :ile away f ! home or regul> place ( bus9ess ( ! memb] 9 ! p]=mance ( ! duties ( ! ,commission4 7#c7 ,coop]ation ,! ,commission may secure directly f any ,f$]al dep>tm5t or ag5cy su* in=mation z ! ,commission consid]s necess>y to c>ry out ?is ,act4 ,^u reque/ ( ! ,*airman ( ! ,commission1 ! head ( su* dep>tm5t or ag5cy %all furni% su* in=mation to ! ,commission4 7e7 ,p]man5t ,commission ,section #ajac ( title #e1 ,unit$ ,/ates ,code1 %all n apply to ! ,commission4 7f7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ = fiscal ye> #bjbe & ea* fiscal ye> !reaft] su* sums z may be necess>y to c>ry out ! duties ( ! ,commission4 #i4 ,grants = hospitals to promote equitable heal? c>e & outcomes 7a7 ,9 g5]al ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is section ref]r$ to z ! ,secret>y7 %all aw>d grants to hospitals to promote equitable heal? c>e treatm5t & s]vices1 & r$uce disp>ities 9 c>e & outcomes4 7b7 ,consultation ,9 e/abli%+ ! crit]ia = grants "u ?is section & evaluat+ applications = su* grants1 ! ,secret>y %all consult ) ! ,director = ,civil ,rights & ,heal? ,equity ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices4 7c7 ,use ( funds ,a hospital %all use funds receiv$ f a grant "u ?is section to e/abli% or exp& programs to provide equitable heal? c>e to all pati5ts & to ensure equitable heal? c>e outcomes4 ,su* uses may include-- 7#a7 provid+ explicit & implicit bias tra9+ to m$ical provid]s & /aff2 7#b7 provid+ translation or int]pretation s]vices = pati5ts2 7#c7 recruit+ & tra9+ a div]se work=ce2 7#d7 track+ data relat$ to c>e & outcomes2 & 7#e7 tra9+ on cultural s5sitivity4 7d7 ,priority ,9 aw>d+ grants "u ?is section1 ! ,secret>y %all give priority to hospitals t h receiv$ disproportionate %>e hospital paym5ts "u section #ahhf7r7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7r77 or section #aibc ( su* ,act 7#db ,u4,s4,c4 #acifr-#d7 ) respect to fiscal ye> #bjba4 7e7 ,supplem5t1 n supplant ,grants aw>d$ "u ?is section %all be us$ to supplem5t1 n supplant1 any nongov]nm5t ef=ts1 or o!r ,f$]al1 ,/ate1 or local funds provid$ to a recipi5t4 7f7 ,equitable heal? c>e def9$ ,! t]m equitable heal? c>e has ! mean+ giv5 su* t]m 9 section #ahhf7;b77#c77;,b77viii77,,xiii77cc7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acieww7b77#c77;,b77viii77,,xiii77cc771 z add$ by section #d7;a74