By: Landgraf, et al. H.B. No. 119
        (Senate Sponsor - Zaffirini, Seliger)
         (In the Senate - Received from the House March 25, 2021;
  April 8, 2021, read first time and referred to Committee on Health &
  Human Services; April 26, 2021, reported adversely, with
  favorable Committee Substitute by the following vote:   Yeas 9,  
  Nays 0; April 26, 2021, sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR H.B. No. 119 By:  Buckingham
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to prohibiting organ transplant recipient discrimination
  on the basis of certain disabilities.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  The heading to Subchapter S, Chapter 161, Health
  and Safety Code, is amended to read as follows:
  SUBCHAPTER S. ALLOCATION OF KIDNEYS AND OTHER ORGANS AVAILABLE FOR
  TRANSPLANT
         SECTION 2.  Section 161.471, Health and Safety Code, is
  amended to read as follows:
         Sec. 161.471.  DEFINITIONS [DEFINITION]. In this
  subchapter:
               (1)  "Auxiliary aids and services" means:
                     (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 materials available
  to individuals with visual impairments;
                     (C)  provision of information in a format readily
  accessible and understandable to individuals with cognitive,
  neurological, developmental, or intellectual disabilities;
                     (D)  acquisition or modification of equipment or
  devices; and
                     (E)  other services and actions similar to those
  described by Paragraphs (A), (B), (C), and (D).
               (2)  "Disability" has the meaning assigned by the
  Americans with Disabilities Act of 1990 (42 U.S.C. Section 12101 et
  seq.).
               (3)  "Health care facility" means a facility licensed,
  certified, or otherwise authorized to provide health care in the
  ordinary course of business, including a hospital, nursing
  facility, laboratory, intermediate care facility, mental health
  facility, transplant center, and any other facility for individuals
  with intellectual or developmental disabilities.
               (4)  "Health care provider" means an individual or
  facility licensed, certified, or otherwise authorized to provide
  health care in the ordinary course of business or professional
  practice, including a physician, hospital, nursing facility,
  laboratory, intermediate care facility, mental health facility,
  transplant center, and any other facility for individuals with
  intellectual or developmental disabilities.
               (5)  "Organ [, "organ] procurement organization" means
  an organization that is a qualified organ procurement organization
  under 42 U.S.C. Section 273 that is currently certified or
  recertified in accordance with that federal law.
         SECTION 3.  Subchapter S, Chapter 161, Health and Safety
  Code, is amended by adding Section 161.473 to read as follows:
         Sec. 161.473.  DISCRIMINATION ON BASIS OF DISABILITY
  PROHIBITED. (a)  A health care provider may not, solely on the
  basis of an individual's disability:
               (1)  determine an individual is ineligible to receive
  an organ transplant;
               (2)  deny medical or other services related to an organ
  transplant, including evaluation, surgery, counseling, and
  postoperative treatment;
               (3)  refuse to refer the individual to a transplant
  center or other related specialist for evaluation or receipt of an
  organ transplant; or
               (4)  refuse to place the individual on an organ
  transplant waiting list or place the individual at a position lower
  in priority on the list than the position the individual would have
  been placed if not for the individual's disability.
         (b)  Notwithstanding Subsection (a), a health care provider
  may consider an individual's disability when making a treatment
  recommendation or decision solely to the extent that a physician,
  following an individualized evaluation of the potential transplant
  recipient, determines the disability is medically significant to
  the organ transplant. This section does not require a referral or
  recommendation for, or the performance of, a medically
  inappropriate organ transplant.
         (c)  A health care provider may not consider an individual's
  inability to independently comply with post-transplant medical
  requirements as medically significant for the purposes of
  Subsection (b) if the individual has:
               (1)  a known disability; and
               (2)  the necessary support system to assist the
  individual in reasonably complying with the requirements.
         (d)  A health care facility shall make reasonable
  modifications in policies, practices, or procedures as necessary to
  allow individuals with a disability access to organ
  transplant-related services, including transplant-related
  counseling, information, or treatment, unless the health care
  facility can demonstrate that making the modifications would
  fundamentally alter the nature of the services or would impose an
  undue hardship on the facility. Reasonable modifications in
  policies, practices, and procedures may include:
               (1)  communicating with persons supporting or
  assisting with the individual's postsurgical and post-transplant
  care, including medication; and
               (2)  considering the support available to the
  individual in determining whether the individual is able to
  reasonably comply with post-transplant medical requirements,
  including support provided by:
                     (A)  family;
                     (B)  friends; or
                     (C)  home and community-based services, including
  home and community-based services funded by:
                           (i)  Medicaid;
                           (ii)  Medicare;
                           (iii)  a health plan in which the individual
  is enrolled; or
                           (iv)  any other program or source of funding
  available to the individual.
         (e)  A health care provider shall make reasonable efforts to
  comply with the policies, practices, and procedures, as applicable,
  developed by a health care facility under Subsection (d), as
  necessary to allow an individual with a known disability access to
  organ transplant-related services, including transplant-related
  counseling, information, or treatment, unless the health care
  provider can demonstrate that compliance would fundamentally alter
  the nature of the services or would impose an undue hardship on the
  health care provider.
         (f)  A health care provider shall make reasonable efforts to
  provide auxiliary aids and services to an individual with a known
  disability seeking organ transplant-related services, including
  organ transplant-related counseling, information, or treatment, as
  necessary to allow the individual access to those services, unless
  the health care provider can demonstrate that providing the
  transplant-related services with auxiliary aids and services
  present would fundamentally alter the transplant-related services
  provided or would impose an undue hardship on the health care
  provider.
         (g)  A health care provider shall comply with the
  requirements of the Americans with Disabilities Act of 1990 (42
  U.S.C. Section 12101 et seq.) to the extent that Act applies to a
  health care provider. This subsection may not be construed to
  require a health care provider to comply with that Act if the Act
  does not otherwise require compliance by the health care provider.
         (h)  This section applies to each stage of the organ
  transplant process.
         (i)  A violation of this section is grounds for disciplinary
  action by the regulatory agency that issued a license, certificate,
  or other authority to a health care provider who committed the
  violation. Before a regulatory agency may take disciplinary action
  against a health care provider for a violation, the applicable
  regulatory agency shall:
               (1)  notify the health care provider of the agency's
  finding that the health care provider has violated or is violating
  this section or a rule adopted under this section; and
               (2)  provide the health care provider with an
  opportunity to correct the violation without penalty or reprimand.
         (j)  A physician who in good faith makes a determination that
  an individual's disability is medically significant to the organ
  transplant, as described by Subsection (b), does not violate this
  section.
         (k)  A health care provider who in good faith makes a
  treatment recommendation or decision on the basis of a physician's
  determination that an individual's disability is medically
  significant to the organ transplant, as described by Subsection
  (b), does not violate this section.
         SECTION 4.  Not later than January 1, 2022, the executive
  commissioner of the Health and Human Services Commission shall
  adopt any rules necessary to implement Subchapter S, Chapter 161,
  Health and Safety Code, as amended by this Act.
         SECTION 5.  This Act takes effect September 1, 2021.
 
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