I 

116TH CONGRESS 

2D SESSION H. R. 8981 

To prohibit discrimination on the basis of mental or physical disability in 

cases of anatomical gifts and organ transplants. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 16, 2020 

Ms. HERRERA BEUTLER (for herself and Ms. PORTER) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To prohibit discrimination on the basis of mental or physical 

disability in cases of anatomical gifts and organ transplants. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Charlotte Woodward 

5 Organ Transplant Discrimination Prevention Act’’. 

6 SEC. 2. DEFINITIONS. 

7 For purposes of this Act: 

8 (1) ANATOMICAL GIFT.—The term ‘‘anatomical 

9 gift’’ means a donation of all or part of a human 


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1 body that takes effect after the death of the donor 

2 for the purpose of transplantation or transfusion. 

3 (2) AUXILIARY AIDS AND SERVICES.—The term 

4 ‘‘auxiliary aids and services’’ includes— 

5 (A) qualified interpreters or other effective 

6 methods of making aurally delivered materials 

7 available to individuals with hearing impair8 ments; 

9 (B) qualified readers, taped texts, or other 

10 effective methods of making visually delivered 

11 materials available to individuals with visual im12 pairments; 

13 (C) provision of information in a format 

14 that is accessible for individuals with cognitive, 

15 neurological, developmental, or intellectual dis16 abilities; 

17 (D) provision of supported decision-making 

18 services; and 

19 (E) acquisition or modification of equip20 ment or devices. 

21 (3) COVERED ENTITY.—The term ‘‘covered en22 tity’’ means— 

23 (A) any licensed provider of health care 

24 services, including licensed health care practi25 tioners, hospitals, nursing facilities, laboraVerDate Sep 11 2014 02:28 Jan 02, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H8981.IH H8981

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1 tories, intermediate care facilities, psychiatric 

2 residential treatment facilities, institutions for 

3 individuals with intellectual or developmental 

4 disabilities, and prison health centers; or 

5 (B) any entity responsible for matching 

6 anatomical gift donors to potential recipients. 

7 (4) DISABILITY.—The term ‘‘disability’’ has the 

8 same meaning given such term in section 4 of the 

9 Americans with Disabilities Act of 1990. 

10 (5) ORGAN TRANSPLANT.—The term ‘‘organ 

11 transplant’’ means the transplantation or trans12 fusion of a part of a human body into the body of 

13 another for the purpose of treating or curing a med14 ical condition. 

15 (6) QUALIFIED INDIVIDUAL.—The term ‘‘quali16 fied individual’’ means an individual who, with or 

17 without a support network, provision of auxiliary 

18 aids and services, or reasonable modifications to 

19 policies or practices, meets eligibility requirements 

20 for the receipt of an anatomical gift. 

21 (7) REASONABLE MODIFICATIONS TO POLICIES

22 OR PRACTICES.—The term ‘‘reasonable modifications 

23 to policies or practices’’ include— 

24 (A) communication with individuals re25 sponsible for supporting an individual with 


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1 postsurgical and post-transplantation care, in2 cluding medication; and 

3 (B) consideration of support networks 

4 available to the individual, including family, 

5 friends, and home and community-based serv6 ices, including home and community-based serv7 ices funded through medicaid, medicare, an8 other health plan in which the individual is en9 rolled, or any program or source of funding 

10 available to the individual, in determining 

11 whether the individual is able to comply with 

12 posttransplant medical requirements. 

13 (8) SECRETARY.—The term ‘‘Secretary’’ means 

14 the Secretary of Health and Human Services. 

15 (9) SUPPORTED DECISION MAKING.—The term 

16 ‘‘supported decision making’’ means the use of a 

17 support person to assist an individual in making 

18 medical decisions, communicate information to the 

19 individual, or ascertain an individual’s wishes. Such 

20 term may include— 

21 (A) the inclusion of the individual’s attor22 ney-in-fact, health care proxy, or any person of 

23 the individual’s choice in communications about 

24 the individual’s medical care; 


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1 (B) permitting the individual to designate 

2 a person of their choice for the purposes of sup3 porting that individual in communicating, proc4 essing information, or making medical deci5 sions; 

6 (C) providing auxiliary aids and services to 

7 facilitate the individual’s ability to communicate 

8 and process health-related information, includ9 ing use of assistive communication technology; 

10 (D) providing information to persons des11 ignated by the individual, consistent with the 

12 provisions of the Health Insurance Portability 

13 and Accountability Act of 1996 (4 U.S.C. 13 et 

14 seq.), and other applicable laws and regulations 

15 governing disclosure of health information; 

16 (E) providing health information in a for17 mat that is readily understandable by the indi18 vidual; and 

19 (F) working with a court-appointed guard20 ian or other individual responsible for making 

21 medical decisions on behalf of the individual, to 

22 ensure that the individual is included in deci23 sions involving the health care of the individual 

24 and that medical decisions are in accordance 

25 with the individual’s own expressed interests. 


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1 (10) SUPPORT NETWORK.—The term ‘‘support 

2 network’’ means, with respect to a person, one or 

3 more individuals selected by the person or by the 

4 person and the guardian of the person, to provide 

5 assistance to that person or guidance to that person 

6 in understanding issues, making plans for the fu7 ture, or making complex decisions, including the per8 son’s family, friends, unpaid supporters, religious 

9 congregations, and community centers. 

10 SEC. 3. PROHIBITION OF DISCRIMINATION. 

11 (a) IN GENERAL.—Subject to subsection (b), a cov12 ered entity may not, solely on the basis of a qualified indi13 vidual’s mental or physical disability— 

14 (1) deem such individual ineligible to receive an 

15 anatomical gift or organ transplant; 

16 (2) deny such individual medical or related 

17 organ transplantation services, including evaluation, 

18 surgery, counseling, and postoperative treatment and 

19 care; 

20 (3) refuse to refer the individual to a transplant 

21 center or other related specialist for the purpose of 

22 evaluation or receipt of an organ transplant; 

23 (4) refuse to place an individual on an organ 

24 transplant waiting list, or placement of the indi25 vidual at a lower-priority position on the list than 


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1 the position at which the individual would have been 

2 placed if not for the disability of the individual; or 

3 (5) decline insurance coverage for such indi4 vidual for any procedure associated with the receipt 

5 of an anatomical gift, including post-transplantation 

6 care if such procedure would be covered under such 

7 coverage for such individual if not for the disability 

8 of the individual. 

9 (b) EXCEPTION.— 

10 (1) IN GENERAL.—Notwithstanding subsection 

11 (a), a covered entity may take an individual’s dis12 ability into account when making treatment or cov13 erage recommendations or decisions, solely to the ex14 tent that the physical or mental disability has been 

15 found by a physician, following an individualized 

16 evaluation of the potential recipient, to be medically 

17 significant to the provision of the anatomical gift. 

18 The previous sentence shall not be treated as requir19 ing referrals or recommendations for, or the per20 formance of, medically inappropriate organ trans21 plants. 

22 (2) CLARIFICATION.—If an individual has the 

23 necessary support system to provide reasonable as24 surance that the individual will comply with 

25 posttransplant medical requirements, the individual’s 


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1 inability to independently comply with those require2 ments may not be deemed to be medically significant 

3 for purposes of paragraph (1). 

4 (c) REASONABLE MODIFICATIONS.—A covered entity 

5 shall make reasonable modifications to policies, practices, 

6 or procedures of such entity if such modifications are nec7 essary to make services such as transplantation-related 

8 counseling, information, coverage, or treatment available 

9 to qualified individuals with disabilities, unless the entity 

10 can demonstrate that making such modifications would 

11 fundamentally alter the nature of such services. 

12 (d) CLARIFICATIONS.— 

13 (1) A covered entity shall take such steps as 

14 may be necessary to ensure that no qualified indi15 vidual with a disability is denied services such as 

16 transplantation-related counseling, information, cov17 erage, or treatment because of the absence of auxil18 iary aids and services, unless the entity can dem19 onstrate that taking such steps would fundamentally 

20 alter the nature of the services being offered or 

21 would result in an undue burden. 

22 (2) A covered entity shall otherwise comply with 

23 the requirements of titles II and III of the Ameri24 cans with Disabilities Act of 1990 and the Ameri25 cans with Disabilities Act Amendments Act of 2008. 


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1 (3) The provisions of this section apply to each 

2 part of the organ transplant process. 

3 SEC. 4. ENFORCEMENT. 

4 (a) IN GENERAL.—Any individual with a claim, with 

5 respect to a covered entity, to be (or to have been) subject 

6 to discrimination in violation of section 3— 

7 (1) may bring such a claim to the Office for 

8 Civil Rights of the Department of Health and 

9 Human Services for expedited resolution; and 

10 (2) whether or not such a claim is brought 

11 under paragraph (1) or a violation is found pursuant 

12 to paragraph (1), may bring a civil action before the 

13 appropriate Federal court for injunctive or other eq14 uitable relief, including the relief described in sub15 section (b), against such covered entity to enforce 

16 compliance of such covered entity with such section. 

17 (b) RELIEF AVAILABLE.—The injunctive and equi18 table relief available in a civil action brought under sub19 section (a)(2), with respect to a covered entity, includes— 

20 (1) requiring auxiliary aids or services to be 

21 made available by such entity; 

22 (2) requiring the modification of a policy, prac23 tice, or procedure of such entity; or 

24 (3) requiring facilities of such entity be made 

25 readily accessible and usable. 


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1 (c) EXPEDITED REVIEW.—In the case of a civil ac2 tion brought under subsection (a)(2), with respect to a 

3 covered entity, the Federal court before which such action 

4 is brought shall advance on its docket and expedite review 

5 and disposition of such action. 

6 (d) RULE OF CONSTRUCTION.—Nothing in this sec7 tion is intended to limit or replace available remedies 

8 under the Americans with Disabilities Act of 1990 and 

9 the Americans with Disabilities Act Amendments Act of 

10 2008 or any other applicable law. 

Æ 


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