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STATE OF IOWA
KIM REYNOLDS
GOVERNOR
May 15,2026
The Honorable Paul Pate
Secretaiy of State of Iowa
State Capitol
Des Moines, Iowa 50319
Dear Mr. Secretary,
I hereby transmit:
House File 2562, an Act relating to care facility placement decisions for certain adults,
and including effective date provisions.
The above House File is hereby approved on this date.
Sincerely,
wim KfiynoldsKim
Governor of Iowa
cc: Secretary of the Senate
Clerk of the House
STATE CAPITOL DES MOINES, IOWA 50319 515.281.5211 WWW.GOVERNOR.IOWA.GOV
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House File 2562
AN ACT
RELATING TO CARE FACILITY PLACEMENT DECISIONS FOR CERTAIN
ADULTS, AND INCLUDING EFFECTIVE DATE PROVISIONS.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
DIVISION I
CARE FACILITY PLACEMENT
Section 1. NEW SECTION, 144H.1 Definitions.
For purposes of this chapter, unless the context otherwise
requires:
1. '^Able to consent" means a patient is willing and able
to communicate a decision independently or with appropriate
services, technological assistance, support decision making, or
other reasonable accommodation and is able to understand the
House File 2562, p. 2
nature and consequences of the decision, including the primary
risks and benefits of a decision.
2. ^''Authorized representative" means any of the following;
a, An agent as that term is defined in section 633B.102,
b, An attorney in fact as that term is defined in section
144B.1.
c, A conservator as that term is defined in section
633B.102.
d, A guardian as that term is defined in section 633B.102.
e, A public guardian as that term is defined in chapter
231E.
3. ^Care facility" means a facility that provides a patient
with health-related and personal care services, including any
of the following:
a. A hospital.
b. A medical clinic.
c. A nursing facility.
d» A rehabilitation facility as that term is defined in
section 135C.1.
e. A residential care facility as that term is defined in
section 135C.1.
4. '^Department" means the department of health and human
services•
5. '^Patient" means an adult who is receiving health-related
or personal care services from a care facility.
6. '^Person authorized to consent" means a member of any of
the following groups of individuals, in order of priority, who
is willing and able to consent, refuse to consent, or withdraw
consent on a patient's behalf:
a. The patient's spouse.
b. An adult child of the patient or, if the patient has more
than one adult child, the decision agreed to by half or more of
the adult children reasonably available for consultation with
the patient's physician.
c. A parent or parents of a patient, if one or both parents
are reasonably available for consultation with the patient's
physician.
d. An adult sibling of the patient or, if the patient has
more than one adult sibling, the decision agreed to by half or
House File 2562, p. 3
more of the adult siblings who are reasonably available for
consultation with the patient's physician.
7. '^Placement" mQans the admission, discharge, or transfer
of a patient.
8. "^Public assistance program'^ means a state or federally
funded program including but not limited to:
a. The Medicaid program as that term is defined in section
249A.2.
b. Medicare pursuant to the federal government health
insurance program established under Tit. XVIII of the Social
Security Act.
c. A medical benefits package pursuant to 38 C.F.R. §17.38.
Sec. 2. NEW SECTION. 144H.2 Inability to consent —
certification.
Upon examination of a patient, a physician licensed under
chapter 148 may certify in the patient's medical records
that in the professional opinion of the physician all of the
following are true:
1. The patient is not able to consent.
2. Despite good-faith efforts, an authorized representative
for the patient has not been located by the physician.
3. It is in the patient's best interests to be discharged
from the patient's current care facility and to be transferred
or admitted to a care facility recommended by the physician.
Sec. 3. NEW SECTION. 144H.3 Person authorized to consent —
powers and duties.
1. upon a physician's certification pursuant to section
144H.2, a person authorized to consent is authorized to do any
of the following:
a. Make decisions regarding the patient's care facility
placement.
b. Assist the patient in applying for health insurance
coverage through a private insurer, or applying for a public
assistance program, as necessary to facilitate the patient's
care facility placement.
a. Take any other action expressly authorized by the
patient.
2. A person authorized to consent shall act in good faith
and must consider all of the following:
House File 2562, p. 4
a. The patient's wishes, if known,
b. The patient's rights.
c. The best interests of the patient.
3. A person authorized to consent may, as reasonably
necessary to assist the patient in applying for health
insurance coverage through a private insurer, or applying for a
public assistance program, do any of the following:
a. Access the patient's banking and other financial records
as permitted by state and federal law. This paragraph shall
not be construed to permit the person authorized to consent to
own, manage, use, or dispose of any of the patient's financial
resources without the patient's express consent.
b. Disclose the patient's relevant health information to
a third party. The person authorized to consent shall not
disclose a patient's protected health information in violation
of the federal Health Insurance Portability and Accountability
Act of 1996, Pub. L. No. 104-191.
4. The authority of a person authorized to consent shall
expire upon the earliest of any of the following:
a. The date that the patient's care facility placement
as decided by the person authorized to consent is completed,
and notice of approval or denial of an application for health
insurance coverage through a private insurer, or for a public
assistance program, if applicable, is received by a qualified
employee of the receiving care facility.
b» An authorized representative, or a person authorized to
consent who has higher priority, has been located.
Sec. 4. NEW SECTION. 144H.4 Care facility — duties.
1. A social worker, discharge planner, or other qualified
employee as designated by a patient's current care facility
shall do all of the following with respect to a person
authorized to consent:
a. Inform the person of the person's powers and duties
pursuant to this chapter.
b. Assist the person with identifying a receiving care
facility for the patient that can provide the appropriate
level of care, as recommended by the physician under section
144H.2, to the patient in the least restrictive environment and
consented to by a social worker, intake coordinator, or other
House File 2562, p. 5
qualified employee of the receiving care facility.
2. If a receiving care facility as described in subsection
1 is identified, and the receiving care facility consents to
the transfer, the patient shall be transferred to the receiving
care facility.
Sec. 5. NEW SECTION. 144H,5 Petition for court order,
1. After good-faith efforts to locate an authorized
representative for the patient or a person authorized to
consent, a care facility or attending physician may petition a
court of competent jurisdiction to order any of the following:
a. The patient's care facility placement.
b. The patient's attending physician or a social worker,
intake worker, or other qualified employee of the receiving
care facility to assist the patient to apply for health
insurance coverage through a private insurer or apply for a
public assistance program, if appropriate.
2. The petition made must include the following
information:
a. The name, age, and address where the patient resides, if
known to the petitioner.
b. The name, address, and county of residence of the
petitioner.
c. The relationship of the petitioner to the patient.
d. The address where the patient can be found, if different
from the patient's residential address.
e. A physician's certification pursuant to section 144H.2.
f. An affidavit from the patient's attending physician,
that upon an examination of the patient and consultation with
another health care provider, all of the following are true:
(1) The patient is not able to consent.
(2) The patient has not identified, and despite good-faith
efforts the attending physician has been unable to locate, an
authorized representative or a person authorized to consent.
(3) The receiving care facility placement recommended by
the attending physician is in the patient's best interests.
(4) The receiving care facility placement recommended by
the attending physician will provide the most appropriate level
of care to the patient in the least restrictive environment,
and is within a reasonable proximity to the patient's
House File 2562, p. 6
residence, if applicable.
g. An affidavit from a social worker, discharge planner, or
other qualified employee as designated by the patient's current
care facility attesting to all of the following;
(1) The patient has not identified, and despite good-faith
efforts the current care facility has been unable to locate, an
authorized representative or a person authorized to consent.
(2) The receiving care facility placement recommended
by the patient's attending physician will provide the
most appropriate level of care to the patient in the least
restrictive environment.
(3) Other care facilities within a reasonable proximity
to the patient's residence were considered for placement, if
applicable.
h» An affidavit from a social worker, intake coordinator,
or other qualified employee of the receiving care facility
recommended by the patient's attending physician attesting to
all of the following:
(1) The receiving care facility is an appropriate facility
available for the patient.
(2) The receiving care facility can provide the most
appropriate level of care to the patient in the least
restrictive environment.
(3) The receiving care facility consents to the transfer or
admission of the patient.
i. The name and address of the receiving care facility
recommended by the attending physician.
3. The court may grant the petition if the court finds all
of the following:
a. The patient is not able to consent.
b. Despite good-faith efforts by the attending physician
and the patient's current care facility, an authorized
representative or person authorized to consent has not been
located.
c. Placement in the receiving care facility recommended
by the patient's attending physician is in the patient's best
interest.
d. Placement in the receiving care facility recommended
by the patient's attending physician will provide the
House File 2562, p. 7
most appropriate level of care to the patient in the least
restrictive environment.
e, A social worker, intake coordinator, or other qualified
employee of the receiving care facility recommended by the
patient's attending physician has consented to the admission
of the patient.
4. If the court grants the petition under subsection 3, the
court shall also order, if necessary, that a qualified employee
of the receiving care facility has the authority to apply for a
public assistance program on the patient's behalf.
5. An order authorizing placement pursuant to this section
shall remain in effect until the earliest of any of the
following:
a. A date specified by the court not to exceed thirty
calendar days from the date of issuance of the order.
b. The date the patient's placement in the receiving care
facility as ordered by the court is completed.
c. The date an attending physician certifies that the
patient is able to consent to the patient's placement in the
receiving care facility.
6. An order authorizing a qualified employee of a receiving
facility to apply for a public assistance program on a
patient's behalf pursuant to this section shall remain in
effect until the earliest of any of the following:
a. A date specified by the court.
b. Notice of approval or denial of an application for health
insurance coverage through a private insurer, or for a public
assistance program is received by a qualified employee of the
receiving facility.
c. The date that an attending physician certifies that the
patient is able to consent to the application for a public
assistance program.
Sec. 6. NEW SECTION. 144H.6 Division of aging and
disability services — notification.
1. Upon completion of a physician's certification pursuant
to section 144H.2, and prior to a person authorized to consent
taking any action under section 144H.3, the patient's attending
physician shall forward a copy of the physician's certification
to the department's division of aging and disability services.
House File 2562, p. 8
2. At least ten days prior to a care facility or an
attending physician petitioning the court for an order
under section 144H,5, the care facility or the patient's
attending physician shall forward a copy of the petition to the
department's division of aging and disability services.
3. Upon granting a petition pursuant to section 144H.5,
the court shall forward a copy of the court order to the
department's division of aging and disability services.
4. A receiving care facility placing a patient pursuant
to section 144H.3, or a court order under section 144H.5,
shall notify the department's division of aging and disability
services upon completion of the patient's placement at the
receiving care facility.
Sec. 7. NEW SECTION. 144H.7 Immunity — liability and
professional discipline.
1. A person or care facility acting in good faith pursuant
to this chapter shall not be subject to civil or criminal
liability.
2. A licensee under chapter 148 acting reasonably and in
good faith pursuant to this chapter shall not be subject to
licensee discipline.
Sec. 8. NEW SECTION. 144H,8 Construction.
This chapter shall not be construed to do any of the
following:
1. Require a care facility to accept the transfer or
admission of a patient.
2. Repeal, abrogate, or impair the operation of any other
federal or state laws governing the transfer, admission, or
discharge of a patient to or from a care facility.
3. Infringe upon the rights of a patient under federal or
state law relating to the involuntary transfer, admission, or
discharge to or from a care facility.
Sec. 9. NEW SECTION, 144H.9 Rules.
The department may promulgate rules pursuant to chapter 17A
as necessary to administer this chapter.
DIVISION II
PERSONS AUTHORIZED TO CONSENT CONTINGENT ON ENACTMENT OF
LEGISLATION
Sec. 10. Section 144H.1, subsection 6, as enacted in
House Pile 2562, p. 9
division I of this Act, is amended to read as follows:
6. '^Person authorized to consent'' means an individual,
in the same order of priority prescribed in section 144A.7,
subsection 1, paragraph , who shall be guided by the express
or implied intentions of the patient and who is reasonably
available, willing, and competent to consent, refuse to
consent, or withdraw consent on a patient's behalf.
Sec. 11. CONTINGENT EFFECTIVE DATE. This division of this
Act takes effect only if 2026 Iowa Acts, House File 2305, or
successor legislation, amends section 144A.7, subsection 1,
paragraph "^b", and is substantially similar to the following
language:
b. If a patient does not have an attorney in fact, a
guardian appointed pursuant to chapter 633, or a guardian
who has obtained court approval in accordance with section
232D.401, subsection 4, paragraph ^a", the decision may be made
by any of the following individuals, who shall be guided by the
express or implied intentions of the patient, in the following
order of priority if no individual in the previous priority
is reasonably available, willing, and competent to make the
decision:
(1) The patient's spouse,
(2) An adult child of the patient or, if the patient
has more than one adult child, the decision agreed to by a
majority of the adult children who are reasonably available for
consultation with the patient's attending provider.
(3) A parent of the patient or if the patient has more than
one parent, the decision agreed to by both parents if both
are reasonably available for consultation with the patient's
attending provider.
(4) An adult sibling of the patient or, if the patient
has more than one adult sibling, the decision agreed to by a
majority of the adult siblings who are reasonably available for
consultation with the patient's attending provider.
(5) The decision agreed to by a majority of the patient's
adult relatives, including but not limited to grandchildren,
grandparents, aunts, uncles, nieces, nephews, stepchildren,
stepparents, and stepsiblings who are reasonably available for
consultation with the patient's attending provider.
House File 2562, p* 10
(6) A close adult friend
PAT GRASS]
Speaker of/the House
AMY SIlgLAIR
President of the Senate
I hereby certify that this bill originated in the House and
is known as House File 2562, Ninety-first General Assembly.
Approved
%1^2026
MEGWAN NELSON
ChYefrk of^he House
KIM REYNOLDS
Governor