87R2689 EAS-D
 
  By: Zaffirini S.B. No. 1017
 
 
 
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" includes:
                     (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
  accessible to individuals with cognitive, neurological,
  developmental, or intellectual disabilities;
                     (D)  provision of supported decision-making
  services;
                     (E)  acquisition or modification of equipment or
  devices; and
                     (F)  other similar services and actions.
               (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 provider" means:
                     (A)  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, and any other facility for
  individuals with intellectual or developmental disabilities; and
                     (B)  an organ procurement organization.
               (4)  "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.
               (5)  "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, including:
                     (A)  allowing the individual's attorney-in-fact
  or agent under a medical power of attorney or any person the
  individual selects to be included in communications related to the
  individual's medical care;
                     (B)  permitting the individual to designate a
  person to support the individual in communicating, processing
  information, or making medical decisions;
                     (C)  providing auxiliary aids and services to
  assist the individual in communicating and processing
  health-related information, including the use of assistive
  communication technology;
                     (D)  providing information to persons designated
  by the individual in a manner consistent with the Health Insurance
  Portability and Accountability Act of 1996 (Pub. L. No. 104-191),
  regulations adopted under that Act, and other applicable laws and
  regulations governing disclosure of health information;
                     (E)  providing health information in a format that
  is readily understandable by the individual; and
                     (F)  if the individual has a court-appointed
  guardian or other individual responsible for making medical
  decisions on behalf of the individual, ensuring that the individual
  is included in decisions involving the individual's health care and
  that medical decisions are made in accordance with the individual's
  expressed interests.
         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 an organ
  transplant;
               (4)  refuse to place an 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; or
               (5)  decline insurance coverage for any procedure
  associated with the organ transplant, including post-transplant
  care.
         (b)  Notwithstanding Subsection (a), a health care provider
  may consider an individual's disability when making a treatment or
  coverage recommendation or decision solely to the extent that a
  physician or surgeon, following an individualized evaluation of the
  potential 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 the necessary support system
  to assist the individual in complying with the requirements.
         (d)  A health care provider shall make reasonable
  modifications in policies, practices, or procedures as necessary to
  make services, including transplant-related counseling,
  information, coverage, or treatment, available to an individual
  with a disability, unless the health care provider can demonstrate
  that making the modifications would fundamentally alter the nature
  of the services. Reasonable modifications may include:
               (1)  communicating with persons responsible for
  supporting an individual with postsurgical and post-transplant
  care, including medication; and
               (2)  considering the support available to the
  individual in determining whether the individual is able to 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)  the medical assistance program
  established under Chapter 32, Human Resources Code;
                           (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 ensure that an individual
  with a disability is not denied services, including
  transplant-related counseling, information, coverage, or
  treatment, because auxiliary aids and services are absent unless
  the health care provider can demonstrate that providing the
  services with auxiliary aids and services present would
  fundamentally alter the services provided or would impose an undue
  burden on the health care provider.
         (f)  A health care provider shall comply with the
  requirements of Titles II and III of the Americans with
  Disabilities Act of 1990 (42 U.S.C. Section 12131 et seq.).
         (g)  This section applies to each stage of the organ
  transplant process.
         (h)  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.
         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.