,,ii ,calendar ,no4 #dda #aaith ,,congress #b;d ,session ,s4 #aghb ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #ae1 #bjbe,mrs4 ,moody 7for herself1 ,ms4 ,hassan1 ,mr4 ,scott of ,florida1 ,ms4 ,smith1 ,mr4 ,daines1 ,mr4 ,kaine1 ,mrs4 ,hyde-,smith1 ,mr4 ,whitehouse1 ,mrs4 ,blackburn1 ,mr4 ,warner1 ,mr4 ,schmitt1 ,mr4 ,warnock1 ,mr4 ,coons1 ,mr4 ,justice1 ,mr4 ,marshall1 ,mr4 ,kelly1 ,mr4 ,fetterman1 ,mr4 ,van ,hollen1 ,mr4 ,reed1 ,mrs4 ,gillibrand1 ,mr4 ,budd1 and ,mrs4 ,capito7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,june #bb1 #bjbf,reported by ,mr4 ,cassidy1 with an amendment,strike out all after the enacting clause and insert the part printed in italic ,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 ,definitions ,in this ,act3 7#a7 ,auxiliary aids and services ,the term auxiliary aids and services has the meaning given the term in section #d of the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abajc74 7#b7 ,covered entity ,the term covered entity means any licensed provider of health care services 7including 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 centers71 and any transplant hospital 7as defined in section #aba4b of title #db1 ,code of ,federal ,regulations or a successor regulation71 that-- 7,a7 is in interstate commerce2 or 7,b7 provides health care services in a manner that-- 7i7 substantially affects or has a substantial relation to interstate commerce2 or 7ii7 includes use of an instrument 7including an instrument of transportation or communication7 of interstate commerce4 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 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 persons responsible for supporting a qualified individual with postsurgical or other care following an organ transplant or related services1 including support with medication2 7,b7 consideration1 in determining whether a qualified individual will be able to comply with health requirements following an organ transplant or receipt of related services1 of support networks available to the qualified 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 qualified individual is enrolled1 or any program or source of funding available to the qualified individual2 and 7,c7 the use of supported decision-making1 when needed1 by a qualified 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 ,supported decision-making ,the term supported decision-making means the use of a support person to assist a qualified individual in making health care decisions1 communicate information to the qualified individual1 or ascertain a qualified 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 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 person 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#aj7 ,support network ,the term support network means1 with respect to a qualified individual1 #a or more people who are-- 7,a7 selected by the qualified individual or by the qualified individual and the guardian of the qualified individual1 to provide assistance to the qualified individual or guidance to that qualified individual 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 qualified individual4 #c4 ,prohibition of discriminatory policy ,the board of directors described in section #cgb7;b77#a77;,b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bgd7;b77#a77;,b77 shall not issue policies1 recommendations1 or other memoranda that would prohibit1 or otherwise hinder1 a qualified individual's access to an organ transplant solely on the basis of that individual's disability4 #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 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 or 7#d7 refuse to place the individual on an organ transplant waiting list4 7b7 ,exception 7#a7 ,in general 7,a7 ,medically significant disabilities ,notwithstanding subsection 7a71 a covered entity may take a qualified individual's 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 qualified individual will be able to comply with health requirements following an organ transplant or receipt of related services1 as the case may be1 the qualified 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 ,for purposes of this section1 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 because of the absence of auxiliary aids and services1 unless the covered entity can demonstrate that taking such steps would fundamentally alter the nature of the procedure being offered or would result in an undue burden on the entity4 7#b7 ,compliance with other law ,nothing in this section 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 #bjjh 7,public ,law #aaj-cbe71 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 7e7 ,enforcement 7#a7 ,in general ,any individual who alleges that a qualified individual was subject to a violation of this section by a covered entity may bring a claim regarding the allegation to the ,office for ,civil ,rights of the ,department of ,health and ,human ,services1 for expedited resolution1 as appropriate4 7#b7 ,rule of construction ,nothing in this subsection is intended to limit or replace available remedies under the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq47 or any other applicable law4 #e4 ,application to each part of process ,the provisions of this ,act-- 7#a7 that apply to an organ transplant1 also apply to the evaluation and listing of a qualified individual1 and to the organ transplant and post-organ-transplant treatment of such an individual2 and 7#b7 that apply to related services1 also apply to the process for receipt of related services by such an individual4 #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 #a4 ,short title ,this ,act may be cited as the ,charlotte ,woodward ,organ ,transplant ,discrimination ,prevention ,act4 #b4 ,definitions ,in this ,act3 7#a7 ,auxiliary aids and services ,the term auxiliary aids and services has the meaning given the term in section #d of the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abajc74 7#b7 ,covered entity ,the term covered entity means any-- 7,a7 entity operating a program or activity1 involving an organ transplant or related services1 receiving ,federal financial assistance2 or 7,b7 public entity covered by title ,,ii of the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaca et seq47 that carries out activities relating to such a transplant or services4 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 ,organ ,the term organ has the meaning given the term human organ in section #cja7;c7 of the ,national ,organ ,transplant ,act 7#db ,u4,s4,c4 #bgd;e7c774 7#e7 ,qualified individual with a disability ,the term qualified individual with a disability means such individual within the meaning of the term as used in title ,,ii of the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaca et seq471 section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 and any other applicable ,federal law1 including their implementing regulations4 7#f7 ,reasonable modifications ,the term reasonable modifications means such modifications within the meaning of the term as used in or for the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq471 section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 and any other applicable ,federal law1 including their implementing regulations4 7#g7 ,related services ,the term related services means services1 including the process by which an individual receives such services1 related to an organ transplant that consist of-- 7,a7 evaluation and listing on the transplant waiting lists2 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 #c4 ,prohibition of discriminatory policy ,section #cgb7;b77#b77;,b7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bgd7;b77#b77;,b77 is amended to read as follows3 7,b7 establish membership criteria and medical criteria for allocating organs1 which shall not include medical criteria that would discriminate on the basis of disability in access to an organ transplant1 and provide to members of the public an opportunity to comment with respect to such membership and medical criteria2 4 #d4 ,prohibition of discrimination 7a7 ,in general ,consistent with section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq471 and any other applicable ,federal law1 including their implementing regulations1 and1 subject to subsection 7b71 a covered entity shall not1 on the basis of the disability of a qualified individual with a 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 the transplant waiting lists2 or 7#e7 otherwise discriminate based on disability with respect to the provision of an organ transplant or related services4 7b7 ,exception 7#a7 ,professional judgment in treatment ,notwithstanding subsection 7a71 following an individualized assessment by a covered entity1 the covered entity may take the disability of a qualified individual with a disability into account in carrying out a program or activity consistent with section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq471 and any other applicable ,federal law1 including their implementing regulations1 including section #hd4ef of title #de1 ,code of ,federal ,regulations1 as in effect on the date of enactment of this ,act4 7#b7 ,clarification ,if a qualified individual with a disability would be able to comply with the health requirements following an organ transplant or provision of related services if given the necessary reasonable modifications to policies1 practices1 or procedures1 or appropriate auxiliary aids and services1 the individual's inability to independently comply with those requirements may not be taken into account for purposes of paragraph 7#a74 7c7 ,clarifications 7#a7 ,reasonable modifications 7,a7 ,in general ,consistent with section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq471 and any other applicable ,federal law1 and their implementing regulations1 a covered entity shall make reasonable modifications to policies1 practices1 or procedures when such modifications are necessary to avoid discrimination on the basis of disability as described in subsection 7a7 except as provided in subsection 7b71 unless the entity can demonstrate that making such modifications would fundamentally alter the nature of the program or activity involved4 7,b7 ,inclusion ,for the purposes of subsection 7b77#b7 and subparagraph 7,a71 the reasonable modifications may include the use of supported decision-making1 when needed1 by a qualified individual with a disability4 7#b7 ,auxiliary aids and services ,consistent with section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq471 and any other applicable ,federal law1 and their implementing regulations1 a covered entity shall take such steps as may be necessary to ensure that no qualified individual with a disability is excluded1 denied services1 segregated1 or otherwise discriminated against1 based on disability1 from or for a procedure associated with the receipt of an organ transplant or related services because of the absence of appropriate auxiliary aids and services1 unless the covered entity can demonstrate that taking such steps would fundamentally alter the nature of the program or activity involved or would result in an undue burden4 7#c7 ,privacy and security of health information ,nothing in this subsection shall be construed to modify or alter the requirements for privacy or security of individually identifiable health information under the privacy1 security1 and breach notification rules under parts #afj and #afd of title #de1 ,code of ,federal ,regulations 7or a successor regulation7 or for the confidentiality of substance use disorder patient records under part #b of title #db1 ,code of ,federal ,regulations 7or a successor regulation74 7d7 ,enforcement ,when a complaint regarding an allegation of discrimination on the basis of disability with respect to the provision of an organ transplant or related services is brought to the ,office for ,civil ,rights of the ,department of ,health and ,human ,services1 such ,office shall consider the complaint1 consistent with the ,office's practices and procedures1 for expedited complaint resolution or early complaint resolution1 as appropriate and as appropriate1 may require a remedy1 consistent with the enforcement remedies for a violation of section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq471 and any other applicable ,federal law1 including their implementing regulations4 7e7 ,report to ,congress 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 and annually thereafter1 the ,secretary shall prepare and submit to the committees specified in paragraph 7#b7 a report that contains-- 7,a7 a description of the activities carried out under this section1 which shall1 at a minimum1 contain-- 7i7 information concerning the number of complaints received related to discrimination as described in subsection 7a72 7ii7 a description of the process by which the ,office for ,civil ,rights of the ,department of ,health and ,human ,services carried out the expedited complaint resolution or early complaint resolution1 where appropriate2 7iii7 the results of such complaints2 and 7iv7 information stating the resources necessary for such ,office to carry out such activities2 and 7,b7 recommendations by the ,secretary to improve enforcement of this ,act4 7#b7 ,submission ,the ,secretary shall submit the report to the ,committee on ,energy and ,commerce of the ,house of ,representatives1 and to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate4 #e4 ,rule of construction ,nothing in this ,act shall be construed to invalidate or limit the rights1 remedies1 and procedures1 including legal standards1 available to an individual aggrieved under-- 7#a7 the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq472 7#b7 section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid72 or 7#c7 any other applicable ,federal or ,state law that provides additional protections against discrimination on the basis of disability with respect to organ transplants or related services4 ,june #bb1 #bjbf,reported with an amendment