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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Charlotte Woodward 
Organ Transplant Discrimination Prevention Act’’. 
SEC. 2. DEFINITIONS. 
For purposes of this Act: 
(1) ANATOMICAL GIFT.—The term ‘‘anatomical 
gift’’ means a donation of all or part of a human 
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body that takes effect after the death of the donor 
for the purpose of transplantation or transfusion. 
(2) AUXILIARY AIDS AND SERVICES.—The term 
‘‘auxiliary aids and services’’ includes— 
(A) qualified interpreters or other effective 
methods of making aurally delivered materials 
available to individuals with hearing impair-
ments; 
(B) qualified readers, taped texts, or other 
effective methods of making visually delivered 
materials available to individuals with visual im-
pairments; 
(C) provision of information in a format 
that is accessible for individuals with cognitive, 
neurological, developmental, or intellectual dis-
abilities; 
(D) provision of supported decision-making 
services; and 
(E) acquisition or modification of equip-
ment or devices. 
(3) COVERED ENTITY.—The term ‘‘covered en-
tity’’ means— 
(A) any licensed provider of health care 
services, including licensed health care practi-
tioners, hospitals, nursing facilities, labora-
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tories, intermediate care facilities, psychiatric 
residential treatment facilities, institutions for 
individuals with intellectual or developmental 
disabilities, and prison health centers; or 
(B) any entity responsible for matching 
anatomical gift donors to potential recipients. 
(4) DISABILITY.—The term ‘‘disability’’ has the 
same meaning given such term in section 4 of the 
Americans with Disabilities Act of 1990. 
(5) ORGAN
TRANSPLANT.—The term ‘‘organ 
transplant’’ means the transplantation or trans-
fusion of a part of a human body into the body of 
another for the purpose of treating or curing a med-
ical condition. 
(6) QUALIFIED INDIVIDUAL.—The term ‘‘quali-
fied individual’’ means an individual who, with or 
without a support network, provision of auxiliary 
aids and services, or reasonable modifications to 
policies or practices, meets eligibility requirements 
for the receipt of an anatomical gift. 
(7) REASONABLE MODIFICATIONS TO POLICIES 
OR PRACTICES.—The term ‘‘reasonable modifications 
to policies or practices’’ include— 
(A) communication with individuals re-
sponsible for supporting an individual with 
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postsurgical and post-transplantation care, in-
cluding medication; and 
(B) consideration of support networks 
available to the individual, including family, 
friends, and home and community-based serv-
ices, including home and community-based serv-
ices funded through medicaid, medicare, an-
other health plan in which the individual is en-
rolled, or any program or source of funding 
available to the individual, in determining 
whether the individual is able to comply with 
posttransplant medical requirements. 
(8) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(9) SUPPORTED DECISION MAKING.—The term 
‘‘supported decision making’’ means the use of a 
support person to assist an individual in making 
medical decisions, communicate information to the 
individual, or ascertain an individual’s wishes. Such 
term may include— 
(A) the inclusion of the individual’s attor-
ney-in-fact, health care proxy, or any person of 
the individual’s choice in communications about 
the individual’s medical care; 
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(B) permitting the individual to designate 
a person of their choice for the purposes of sup-
porting that individual in communicating, proc-
essing information, or making medical deci-
sions; 
(C) providing auxiliary aids and services to 
facilitate the individual’s ability to communicate 
and process health-related information, includ-
ing use of assistive communication technology; 
(D) providing information to persons des-
ignated by the individual, consistent with the 
provisions of the Health Insurance Portability 
and Accountability Act of 1996 (4 U.S.C. 13 et 
seq.), and other applicable laws and regulations 
governing disclosure of health information; 
(E) providing health information in a for-
mat that is readily understandable by the indi-
vidual; and 
(F) working with a court-appointed guard-
ian or other individual responsible for making 
medical decisions on behalf of the individual, to 
ensure that the individual is included in deci-
sions involving the health care of the individual 
and that medical decisions are in accordance 
with the individual’s own expressed interests. 
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(10) SUPPORT NETWORK.—The term ‘‘support 
network’’ means, with respect to a person, one or 
more individuals selected by the person or by the 
person and the guardian of the person, to provide 
assistance to that person or guidance to that person 
in understanding issues, making plans for the fu-
ture, or making complex decisions, including the per-
son’s family, friends, unpaid supporters, religious 
congregations, and community centers. 
SEC. 3. PROHIBITION OF DISCRIMINATION. 
(a) IN GENERAL.—Subject to subsection (b), a cov-
ered entity may not, solely on the basis of a qualified indi-
vidual’s mental or physical disability— 
(1) deem such individual ineligible to receive an 
anatomical gift or organ transplant; 
(2) deny such individual medical or related 
organ transplantation services, including evaluation, 
surgery, counseling, and postoperative treatment and 
care; 
(3) refuse to refer the individual to a transplant 
center or other related specialist for the purpose of 
evaluation or receipt of an organ transplant; 
(4) refuse to place an individual on an organ 
transplant waiting list, or placement of the indi-
vidual at a lower-priority position on the list than 
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the position at which the individual would have been 
placed if not for the disability of the individual; or 
(5) decline insurance coverage for such indi-
vidual for any procedure associated with the receipt 
of an anatomical gift, including post-transplantation 
care if such procedure would be covered under such 
coverage for such individual if not for the disability 
of the individual. 
(b) EXCEPTION.— 
(1) IN GENERAL.—Notwithstanding subsection 
(a), a covered entity may take an individual’s dis-
ability into account when making treatment or cov-
erage recommendations or decisions, solely to the ex-
tent that the physical or mental disability has been 
found by a physician, following an individualized 
evaluation of the potential recipient, to be medically 
significant to the provision of the anatomical gift. 
The previous sentence shall not be treated as requir-
ing referrals or recommendations for, or the per-
formance of, medically inappropriate organ trans-
plants. 
(2) CLARIFICATION.—If an individual has the 
necessary support system to provide reasonable as-
surance that the individual will comply with 
posttransplant medical requirements, the individual’s 
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inability to independently comply with those require-
ments may not be deemed to be medically significant 
for purposes of paragraph (1). 
(c) REASONABLE MODIFICATIONS.—A covered entity 
shall make reasonable modifications to policies, practices, 
or procedures of such entity if such modifications are nec-
essary to make services such as transplantation-related 
counseling, information, coverage, or treatment available 
to qualified individuals with disabilities, unless the entity 
can demonstrate that making such modifications would 
fundamentally alter the nature of such services. 
(d) CLARIFICATIONS.— 
(1) A covered entity shall take such steps as 
may be necessary to ensure that no qualified indi-
vidual with a disability is denied services such as 
transplantation-related counseling, information, cov-
erage, or treatment because of the absence of auxil-
iary aids and services, unless the entity can dem-
onstrate that taking such steps would fundamentally 
alter the nature of the services being offered or 
would result in an undue burden. 
(2) A covered entity shall otherwise comply with 
the requirements of titles II and III of the Ameri-
cans with Disabilities Act of 1990 and the Ameri-
cans with Disabilities Act Amendments Act of 2008. 
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(3) The provisions of this section apply to each 
part of the organ transplant process. 
SEC. 4. ENFORCEMENT. 
(a) IN GENERAL.—Any individual with a claim, with 
respect to a covered entity, to be (or to have been) subject 
to discrimination in violation of section 3— 
(1) may bring such a claim to the Office for 
Civil Rights of the Department of Health and 
Human Services for expedited resolution; and 
(2) whether or not such a claim is brought 
under paragraph (1) or a violation is found pursuant 
to paragraph (1), may bring a civil action before the 
appropriate Federal court for injunctive or other eq-
uitable relief, including the relief described in sub-
section (b), against such covered entity to enforce 
compliance of such covered entity with such section. 
(b) RELIEF AVAILABLE.—The injunctive and equi-
table relief available in a civil action brought under sub-
section (a)(2), with respect to a covered entity, includes— 
(1) requiring auxiliary aids or services to be 
made available by such entity; 
(2) requiring the modification of a policy, prac-
tice, or procedure of such entity; or 
(3) requiring facilities of such entity be made 
readily accessible and usable. 
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(c) EXPEDITED REVIEW.—In the case of a civil ac-
tion brought under subsection (a)(2), with respect to a 
covered entity, the Federal court before which such action 
is brought shall advance on its docket and expedite review 
and disposition of such action. 
(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion is intended to limit or replace available remedies 
under the Americans with Disabilities Act of 1990 and 
the Americans with Disabilities Act Amendments Act of 
2008 or any other applicable law. 
Æ 
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