Alabama 2023 Regular Session

Alabama House Bill HB122 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~HB122ENROLLED~~
	1	+	HB122INTRODUCED
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3		-	5L2V66-3
	3	+	5L2V66-1
4	4		By Representatives Wood (D), Stadthagen, Lipscomb, Butler,
5	5		Baker, Kirkland, Rigsby, Estes, DuBose, Lamb, Brown, Marques,
6	6		Moore (P), Carns, Underwood, Lomax, Kiel, Mooney, Ledbetter,
7	7		Wilcox, Robertson, Collins, Whorton, Rehm, Shaw
8	8		RFD: Health
9	9		First Read: 21-Mar-23
10		-	2023 Regular Session
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18		-	8 ~~HB122 EnrolledHB122 Enrolled~~
	17	+	8 5L2V66-1 03/06/2023 JC (L) tgw 2023-59
19	18		Page 1
20		-	Enrolled, An Act,
	19	+	SYNOPSIS:
	20	+	This bill would prohibit discrimination against
	21	+	an individual from receiving an organ transplant based
	22	+	on the individual having a disability.
	23	+	This bill would also require health care
	24	+	practitioners, hospitals and other health care
	25	+	facilities, and organ transplant centers to provide
	26	+	reasonable accommodations to an individual with a
	27	+	disability in medical need of an anatomical gift or
	28	+	organ transplant.
	29	+	A BILL
	30	+	TO BE ENTITLED
	31	+	AN ACT
21	32		Relating to health care; to prohibit discrimination
22	33		against an individual with a disability in receiving an
23	34		anatomical gift or organ transplant based on his or her
24		-	disability; to require health care providers and organ
	35	+	disability; and to require health care providers and organ
25	36		transplant centers to provide reasonable accommodations to
26	37		individuals with a disability in medical need of an anatomical
27		-	gift or organ transplant; and to provide disabled individuals
28		-	the right to equitable relief.
	38	+	gift or organ transplant.
29	39		BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
30	40		Section 1. This act shall be known and may be cited as
31		-	Exton's Law.
32		-	Section 2. The Legislature finds all of the following:
33		-	(1) A mental or physical disability does not diminish
34		-	an individual's right to health care.
35		-	(2) The Americans with Disabilities Act of 1990
36		-	prohibits discrimination against individuals with
37		-	disabilities, yet many individuals with disabilities still
38		-	experience discrimination in accessing critical health care
39		-	services.
40		-	(3) Historically, individuals with mental and physical
41		-	disabilities have been denied life-saving organ transplants
42		-	based on assumptions their lives are less worthy, they are
43		-	incapable of complying with post-transplant medical regimens,
44		-	or they lack adequate support systems to ensure compliance.
45		-	(4) Although organ transplant centers must consider
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	70	+	Exton's Law.
	71	+	Section 2. The Legislature finds all of the following:
	72	+	(1) A mental or physical disability does not diminish
	73	+	an individual's right to health care.
	74	+	(2) The Americans with Disabilities Act of 1990
	75	+	prohibits discrimination against individuals with
	76	+	disabilities, yet many individuals with disabilities still
	77	+	experience discrimination in accessing critical health care
	78	+	services.
	79	+	(3) Historically, individuals with mental and physical
	80	+	disabilities have been denied life-saving organ transplants
	81	+	based on assumptions that their lives are less worthy, that
	82	+	they are incapable of complying with post-transplant medical
	83	+	regimens, or that they lack adequate support systems to ensure
	84	+	compliance.
	85	+	(4) Although organ transplant centers must consider
75	86		medical and psychosocial criteria when determining if a
76	87		patient is suitable to receive an organ transplant, transplant
77	88		centers that participate in Medicare, Medicaid, and other
78	89		federal funding programs are required to use patient selection
79	90		criteria that result in a fair and nondiscriminatory
80	91		distribution of organs.
81	92		(5) Alabama residents in need of organ transplants are
82	93		entitled to assurances that they will not encounter
83	94		discrimination on the basis of a disability.
84	95		Section 3. As used in this act, the following terms
85	96		have the following meanings:
86	97		(1) ANATOMICAL GIFT. The donation of all or part of a
87		-	human body to take effect after the donor's death for the
88		-	purpose of transplantation or transfusion.
89		-	(2) AUXILIARY AIDS AND SERVICES. Reasonable
90		-	accommodations that include the following:
91		-	a. Qualified interpreters or other effective methods of
92		-	making aurally delivered materials available to individuals
93		-	with hearing impairments.
94		-	b. Qualified readers, taped texts, or other effective
95		-	methods of making visually delivered material available to
96		-	individuals with visual impairments.
97		-	c. Acquisition or modification of equipment or devices.
98		-	d. Any other aid or service that is used to provide
99		-	information in a format that is easily understandable and
100		-	accessible to individuals with cognitive, neurological,
101		-	developmental, or intellectual disabilities.
102		-	(3) COVERED ENTITY. Any of the following:
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	125	+	56 HB122 INTRODUCEDHB122 INTRODUCED
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	127	+	human body to take effect after the donor's death for the
	128	+	purpose of transplantation or transfusion.
	129	+	(2) AUXILIARY AIDS AND SERVICES. Reasonable
	130	+	accomodations that include the following:
	131	+	a. Qualified interpreters or other effective methods of
	132	+	making aurally delivered materials available to individuals
	133	+	with hearing impairments.
	134	+	b. Qualified readers, taped texts, or other effective
	135	+	methods of making visually delivered material available to
	136	+	individuals with visual impairments.
	137	+	c. Acquisition or modification of equipment or devices.
	138	+	d. Any other aid or service that is used to provide
	139	+	information in a format that is easily understandable and
	140	+	accessible to individuals with cognitive, neurological,
	141	+	developmental, or intellectual disabilities.
	142	+	(3) COVERED ENTITY. Any of the following:
132	143		a. A health care provider licensed under Title 34, Code
133	144		of Alabama 1975.
134	145		b. A health care facility licensed under Chapter 21 of
135	146		Title 22, Code of Alabama 1975.
136	147		c. An entity responsible for matching anatomical gift
137	148		donors to potential recipients.
138	149		(4) DISABILITY. The definition as provided in 42 U.S.C.
139	150		§ 12102.
140	151		(5) ORGAN TRANSPLANT. The transplantation or
141	152		transfusion of a part of a human body into the body of another
142	153		for the purpose of treating or curing a medical condition.
143	154		(6) QUALIFIED INDIVIDUAL. An individual with a
144		-	disability who meets the essential eligibility requirements
145		-	for the receipt of an anatomical gift, with or without any of
146		-	the following:
147		-	a. A support network available to the individual.
148		-	b. The provision of auxiliary aids and services.
149		-	c. Access to a covered entity that has made reasonable
150		-	modifications to its policies or practices, including
151		-	modifications to allow both of the following:
152		-	1. Communication with individuals responsible for
153		-	supporting the individual with post-surgical and
154		-	post-transplantation care, including medication.
155		-	2. The consideration of a support network available to
156		-	the individual, including family, friends, and home-based and
157		-	community-based services funded through Medicaid, Medicare, or
158		-	another health plan in which the individual is enrolled, or
159		-	any program or source of funding available to the individual
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	184	+	disability who meets the essential eligibility requirements
	185	+	for the receipt of an anatomical gift, with or without any of
	186	+	the following:
	187	+	a. A support network available to the individual.
	188	+	b. The provision of auxiliary aids and services.
	189	+	c. Access to a covered entity that has made reasonable
	190	+	modifications to its policies or practices, including
	191	+	modifications to allow both of the following:
	192	+	1. Communication with individuals responsible for
	193	+	supporting the individual with post-surgical and
	194	+	post-transplantation care, including medication.
	195	+	2. The consideration of a support network available to
	196	+	the individual, including family, friends, and home-based and
	197	+	community-based services funded through Medicaid, Medicare, or
	198	+	another health plan in which the individual is enrolled, or
	199	+	any program or source of funding available to the individual,
189	200		in determining whether the individual is able to comply with
190	201		post-transplantation medical requirements.
191	202		(7) SUPPORTED DECISION-MAKING. The reasonable
192	203		accommodation of a support person or persons to assist an
193	204		individual in making medical decisions, communicate
194	205		information to the individual, or ascertain an individual's
195	206		wishes, including the following:
196	207		a. The individual's parent, court-appointed guardian,
197	208		legal custodian, attorney-in-fact, or designated health care
198	209		proxy.
199		-	b. A person designated in writing by the individual.
200		-	Section 4. (a) A covered entity may not do any of the
201		-	following based solely on a qualified individual's disability:
202		-	(1) Consider an individual ineligible to receive an
203		-	anatomical gift or organ transplant.
204		-	(2) Deny medical and other services related to
205		-	transplantation, including evaluation, surgery, counseling,
206		-	and post-transplantation treatment and services.
207		-	(3) Refuse to refer the individual to a transplant
208		-	center or other related specialist for the purpose of
209		-	evaluation or receipt of an anatomical gift or organ
210		-	transplant.
211		-	(4) Refuse to place an individual on an organ
212		-	transplant waiting list.
213		-	(5) Place the individual at a lower priority position
214		-	on the list than the position at which he or she would have
215		-	been placed if not for his or her disability.
216		-	(6) Decline insurance coverage for any procedure
	210	+	b. Consistent with the Health Insurance Portability and
	211	+	Accountability Act of 1996, and other applicable laws, rules,
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	241	+	and regulations governing the disclosure of health
	242	+	information:
	243	+	1. A person selected by the individual.
	244	+	2. A person provided by the covered entity.
	245	+	Section 4. (a) A covered entity may not do any of the
	246	+	following based solely on a qualified individual's disability:
	247	+	(1) Consider an individual ineligible to receive an
	248	+	anatomical gift or organ transplant.
	249	+	(2) Deny medical and other services related to
	250	+	transplantation, including evaluation, surgery, counseling,
	251	+	and post-transplantation treatment and services.
	252	+	(3) Refuse to refer the individual to a transplant
	253	+	center or other related specialist for the purpose of
	254	+	evaluation or receipt of an anatomical gift or organ
	255	+	transplant.
	256	+	(4) Refuse to place an individual on an organ
	257	+	transplant waiting list.
	258	+	(5) Place the individual at a lower priority position
	259	+	on the list than the position at which he or she would have
	260	+	been placed if not for his or her disability.
	261	+	(6) Decline insurance coverage for any procedure
246	262		associated with the receipt of the anatomical gift or organ
247	263		transplant, including post-transplantation care.
248	264		(b)(1) Notwithstanding subsection (a), a covered entity
249	265		may take a qualified individual's disability into account when
250	266		making treatment or coverage recommendations or decisions,
251	267		solely to the extent that the disability has been found by a
252	268		physician, following an individualized evaluation of the
253		-	individual, to be medically significant to the provision of
254		-	the anatomical gift or organ transplant.
255		-	(2) If a qualified individual has the necessary support
256		-	system to assist the individual in complying with
257		-	post-transplantation medical requirements, a covered entity
258		-	may not consider the individual's inability to independently
259		-	comply with the post-transplantation medical requirements to
260		-	be medically significant for the purposes of subdivision (1).
261		-	(c) A covered entity shall make reasonable
262		-	modifications in policies, practices, or procedures when the
263		-	modifications are necessary to allow a qualified individual
264		-	access to services, including transplantation-related
265		-	counseling, information, coverage, or treatment, unless the
266		-	covered entity can demonstrate that making the modifications
267		-	would fundamentally alter the nature of the services being
268		-	offered or result in an undue burden.
269		-	(d) A covered entity shall implement auxiliary aids and
270		-	services and supported decision-making services as necessary
271		-	to ensure that a qualified individual is not denied services,
272		-	including transplantation-related counseling, information,
273		-	coverage, or treatment, unless the covered entity can
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	298	+	individual, to be medically significant to the provision of
	299	+	the anatomical gift or organ transplant.
	300	+	(2) If a qualified individual has the necessary support
	301	+	system to assist the individual in complying with
	302	+	post-transplantation medical requirements, a covered entity
	303	+	may not consider the individual's inability to independently
	304	+	comply with the post-transplantation medical requirements to
	305	+	be medically significant for the purposes of subdivision (1).
	306	+	(c) A covered entity shall make reasonable
	307	+	modifications in policies, practices, or procedures, when the
	308	+	modifications are necessary to allow a qualified individual
	309	+	access to services, including transplantation-related
	310	+	counseling, information, coverage, or treatment, unless the
	311	+	covered entity can demonstrate that making the modifications
	312	+	would fundamentally alter the nature of the services being
	313	+	offered or result in an undue burden.
	314	+	(d) A covered entity shall implement auxiliary aids and
	315	+	services and supported decision-making services as necessary
	316	+	to ensure that a qualified individual is not denied services,
	317	+	including transplantation-related counseling, information,
	318	+	coverage, or treatment, unless the covered entity can
303	319		demonstrate that implementation of the accommodations would
304	320		fundamentally alter the nature of the services being offered
305	321		or would result in an undue burden.
306		-	(e) Nothing in this section shall require a covered
307		-	entity to refer or recommend, or to perform, a medically
308		-	inappropriate organ transplant based on medical review.
309		-	Section 5. (a) When it appears that a covered entity
310		-	has violated or is violating this act, the affected individual
311		-	may commence a civil action, limited to injunctive and other
312		-	equitable relief, against the covered entity for purposes of
313		-	enforcing compliance with this act. The action shall be
314		-	brought in the circuit court for the county in which the
315		-	individual resides or was denied the organ transplant or
316		-	referral.
317		-	(b) The court shall give priority on its docket and
318		-	expedited review to an action brought under subsection (a) and
319		-	may grant injunctive or other equitable relief only.
320		-	(c) Nothing in this act is intended to limit or replace
321		-	available remedies under the Americans with Disabilities Act
322		-	of 1990, as amended, or any other applicable law.
323		-	(d) In an action under this section, the Court, in its
324		-	discretion, may allow the prevailing party a reasonable
325		-	attorney fee as part of the costs of the proceeding.
326		-	Section 6. This act shall become effective on the first
	322	+	Section 5. This act shall become effective on the first
327	323		day of the third month following its passage and approval by
328	324		the Governor, or its otherwise becoming law.
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356		-	________________________________________________
357		-	Speaker of the House of Representatives
358		-	________________________________________________
359		-	President and Presiding Officer of the Senate
360		-	House of Representatives
361		-	I hereby certify that the within Act originated in and
362		-	was passed by the House 09-MAY-23 as amended.
363		-	John Treadwell
364		-	Clerk
365		-	Senate 25-May-23 Passed
366		-	House 25-May-23 Concurred in
367		-	Senate Amendment
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