HB122ENROLLED
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By Representatives Wood (D), Stadthagen, Lipscomb, Butler,
Baker, Kirkland, Rigsby, Estes, DuBose, Lamb, Brown, Marques,
Moore (P), Carns, Underwood, Lomax, Kiel, Mooney, Ledbetter,
Wilcox, Robertson, Collins, Whorton, Rehm, Shaw
RFD: Health
First Read: 21-Mar-23
2023 Regular Session
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Enrolled, An Act,
Relating to health care; to prohibit discrimination
against an individual with a disability in receiving an
anatomical gift or organ transplant based on his or her
disability; to require health care providers and organ
transplant centers to provide reasonable accommodations to
individuals with a disability in medical need of an anatomical
gift or organ transplant; and to provide disabled individuals
the right to equitable relief.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. This act shall be known and may be cited as
Exton's Law.
Section 2. The Legislature finds all of the following:
(1) A mental or physical disability does not diminish
an individual's right to health care.
(2) The Americans with Disabilities Act of 1990
prohibits discrimination against individuals with
disabilities, yet many individuals with disabilities still
experience discrimination in accessing critical health care
services.
(3) Historically, individuals with mental and physical
disabilities have been denied life-saving organ transplants
based on assumptions their lives are less worthy, they are
incapable of complying with post-transplant medical regimens,
or they lack adequate support systems to ensure compliance.
(4) Although organ transplant centers must consider
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medical and psychosocial criteria when determining if a
patient is suitable to receive an organ transplant, transplant
centers that participate in Medicare, Medicaid, and other
federal funding programs are required to use patient selection
criteria that result in a fair and nondiscriminatory
distribution of organs.
(5) Alabama residents in need of organ transplants are
entitled to assurances that they will not encounter
discrimination on the basis of a disability.
Section 3. As used in this act, the following terms
have the following meanings:
(1) ANATOMICAL GIFT. The donation of all or part of a
human body to take effect after the donor's death for the
purpose of transplantation or transfusion.
(2) AUXILIARY AIDS AND SERVICES. Reasonable
accommodations that include the following:
a. Qualified interpreters or other effective methods of
making aurally delivered materials available to individuals
with hearing impairments.
b. Qualified readers, taped texts, or other effective
methods of making visually delivered material available to
individuals with visual impairments.
c. Acquisition or modification of equipment or devices.
d. Any other aid or service that is used to provide
information in a format that is easily understandable and
accessible to individuals with cognitive, neurological,
developmental, or intellectual disabilities.
(3) COVERED ENTITY. Any of the following:
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a. A health care provider licensed under Title 34, Code
of Alabama 1975.
b. A health care facility licensed under Chapter 21 of
Title 22, Code of Alabama 1975.
c. An entity responsible for matching anatomical gift
donors to potential recipients.
(4) DISABILITY. The definition as provided in 42 U.S.C.
ยง 12102.
(5) ORGAN TRANSPLANT. The transplantation or
transfusion of a part of a human body into the body of another
for the purpose of treating or curing a medical condition.
(6) QUALIFIED INDIVIDUAL. An individual with a
disability who meets the essential eligibility requirements
for the receipt of an anatomical gift, with or without any of
the following:
a. A support network available to the individual.
b. The provision of auxiliary aids and services.
c. Access to a covered entity that has made reasonable
modifications to its policies or practices, including
modifications to allow both of the following:
1. Communication with individuals responsible for
supporting the individual with post-surgical and
post-transplantation care, including medication.
2. The consideration of a support network available to
the individual, including family, friends, and home-based and
community-based services funded through Medicaid, Medicare, or
another health plan in which the individual is enrolled, or
any program or source of funding available to the individual
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in determining whether the individual is able to comply with
post-transplantation medical requirements.
(7) SUPPORTED DECISION-MAKING. The reasonable
accommodation of a support person or persons to assist an
individual in making medical decisions, communicate
information to the individual, or ascertain an individual's
wishes, including the following:
a. The individual's parent, court-appointed guardian,
legal custodian, attorney-in-fact, or designated health care
proxy.
b. A person designated in writing by the individual.
Section 4. (a) A covered entity may not do any of the
following based solely on a qualified individual's disability:
(1) Consider an individual ineligible to receive an
anatomical gift or organ transplant.
(2) Deny medical and other services related to
transplantation, including evaluation, surgery, counseling,
and post-transplantation treatment and services.
(3) Refuse to refer the individual to a transplant
center or other related specialist for the purpose of
evaluation or receipt of an anatomical gift or organ
transplant.
(4) Refuse to place an individual on an organ
transplant waiting list.
(5) Place the individual at a lower priority position
on the list than the position at which he or she would have
been placed if not for his or her disability.
(6) Decline insurance coverage for any procedure
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associated with the receipt of the anatomical gift or organ
transplant, including post-transplantation care.
(b)(1) Notwithstanding subsection (a), a covered entity
may take a qualified individual's disability into account when
making treatment or coverage recommendations or decisions,
solely to the extent that the disability has been found by a
physician, following an individualized evaluation of the
individual, to be medically significant to the provision of
the anatomical gift or organ transplant.
(2) If a qualified individual has the necessary support
system to assist the individual in complying with
post-transplantation medical requirements, a covered entity
may not consider the individual's inability to independently
comply with the post-transplantation medical requirements to
be medically significant for the purposes of subdivision (1).
(c) A covered entity shall make reasonable
modifications in policies, practices, or procedures when the
modifications are necessary to allow a qualified individual
access to services, including transplantation-related
counseling, information, coverage, or treatment, unless the
covered entity can demonstrate that making the modifications
would fundamentally alter the nature of the services being
offered or result in an undue burden.
(d) A covered entity shall implement auxiliary aids and
services and supported decision-making services as necessary
to ensure that a qualified individual is not denied services,
including transplantation-related counseling, information,
coverage, or treatment, unless the covered entity can
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demonstrate that implementation of the accommodations would
fundamentally alter the nature of the services being offered
or would result in an undue burden.
(e) Nothing in this section shall require a covered
entity to refer or recommend, or to perform, a medically
inappropriate organ transplant based on medical review.
Section 5. (a) When it appears that a covered entity
has violated or is violating this act, the affected individual
may commence a civil action, limited to injunctive and other
equitable relief, against the covered entity for purposes of
enforcing compliance with this act. The action shall be
brought in the circuit court for the county in which the
individual resides or was denied the organ transplant or
referral.
(b) The court shall give priority on its docket and
expedited review to an action brought under subsection (a) and
may grant injunctive or other equitable relief only.
(c) Nothing in this act is intended to limit or replace
available remedies under the Americans with Disabilities Act
of 1990, as amended, or any other applicable law.
(d) In an action under this section, the Court, in its
discretion, may allow the prevailing party a reasonable
attorney fee as part of the costs of the proceeding.
Section 6. This act shall become effective on the first
day of the third month following its passage and approval by
the Governor, or its otherwise becoming law.
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________________________________________________
Speaker of the House of Representatives
________________________________________________
President and Presiding Officer of the Senate
House of Representatives
I hereby certify that the within Act originated in and
was passed by the House 09-MAY-23 as amended.
John Treadwell
Clerk
Senate 25-May-23 Passed
House 25-May-23 Concurred in
Senate Amendment
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