Read the full stored bill text
Senate
File
2423
-
Introduced
SENATE
FILE
2423
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
SSB
3096)
A
BILL
FOR
An
Act
relating
to
care
facility
placement
decisions
for
1
certain
adults.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
TLSB
5341SV
(2)
91
ak/ko
S.F.
2423
Section
1.
NEW
SECTION
.
144H.1
Definitions.
1
For
purposes
of
this
chapter,
unless
the
context
otherwise
2
requires:
3
1.
“Able
to
consent”
means
a
patient
is
willing
and
able
4
to
communicate
a
decision
independently
or
with
appropriate
5
services,
technological
assistance,
support
decision
making,
or
6
other
reasonable
accommodation
and
is
able
to
understand
the
7
nature
and
consequences
of
the
decision,
including
the
primary
8
risks
and
benefits
of
a
decision.
9
2.
“Authorized
representative”
means
any
of
the
following:
10
a.
An
agent
as
that
term
is
defined
in
section
633B.102.
11
b.
An
attorney
in
fact
as
that
term
is
defined
in
section
12
144B.1.
13
c.
A
conservator
as
that
term
is
defined
in
section
14
633B.102.
15
d.
A
guardian
as
that
term
is
defined
in
section
633B.102.
16
e.
A
public
guardian
as
that
term
is
defined
in
chapter
17
231E.
18
3.
“Care
facility”
means
a
facility
that
provides
a
patient
19
with
health-related
and
personal
care
services,
including
any
20
of
the
following:
21
a.
A
hospital.
22
b.
A
medical
clinic.
23
c.
A
nursing
facility.
24
d.
A
rehabilitation
facility
as
that
term
is
defined
in
25
section
135C.1.
26
e.
A
residential
care
facility
as
that
term
is
defined
in
27
section
135C.1.
28
4.
“Department”
means
the
department
of
health
and
human
29
services.
30
5.
“Patient”
means
an
adult
who
is
receiving
health-related
31
or
personal
care
services
from
a
care
facility.
32
6.
“Person
authorized
to
consent”
means
a
member
of
any
of
33
the
following
groups
of
individuals,
in
order
of
priority,
who
34
is
willing
and
able
to
consent,
refuse
to
consent,
or
withdraw
35
-1-
LSB
5341SV
(2)
91
ak/ko
1/
11
S.F.
2423
consent
on
a
patient’s
behalf:
1
a.
The
patient’s
spouse.
2
b.
An
adult
child
of
the
patient
or,
if
the
patient
has
more
3
than
one
adult
child,
the
decision
agreed
to
by
half
or
more
of
4
the
adult
children
reasonably
available
for
consultation
with
5
the
patient’s
physician.
6
c.
A
parent
or
parents
of
a
patient,
if
one
or
both
parents
7
are
reasonably
available
for
consultation
with
the
patient’s
8
physician.
9
d.
An
adult
sibling
of
the
patient
or,
if
the
patient
has
10
more
than
one
adult
sibling,
the
decision
agreed
to
by
half
or
11
more
of
the
adult
siblings
who
are
reasonably
available
for
12
consultation
with
the
patient’s
physician.
13
7.
“Placement”
means
the
admission,
discharge,
or
transfer
14
of
a
patient.
15
8.
“Public
assistance
program”
means
a
state
or
federally
16
funded
program
including
but
not
limited
to:
17
a.
The
Medicaid
program
as
that
term
is
defined
in
section
18
249A.2.
19
b.
Medicare
pursuant
to
the
federal
government
health
20
insurance
program
established
under
Tit.
XVIII
of
the
Social
21
Security
Act.
22
c.
A
medical
benefits
package
pursuant
to
38
C.F.R.
§17.38.
23
Sec.
2.
NEW
SECTION
.
144H.2
Inability
to
consent
——
24
certification.
25
Upon
examination
of
a
patient,
a
physician
licensed
under
26
chapter
148
may
certify
in
the
patient’s
medical
records
27
that
in
the
professional
opinion
of
the
physician
all
of
the
28
following
are
true:
29
1.
The
patient
is
not
able
to
consent.
30
2.
Despite
good-faith
efforts,
an
authorized
representative
31
for
the
patient
has
not
been
located
by
the
physician.
32
3.
It
is
in
the
patient’s
best
interests
to
be
discharged
33
from
the
patient’s
current
care
facility
and
to
be
transferred
34
or
admitted
to
a
care
facility
recommended
by
the
physician.
35
-2-
LSB
5341SV
(2)
91
ak/ko
2/
11
S.F.
2423
Sec.
3.
NEW
SECTION
.
144H.3
Person
authorized
to
consent
——
1
powers
and
duties.
2
1.
Upon
a
physician’s
certification
pursuant
to
section
3
144H.2,
a
person
authorized
to
consent
is
authorized
to
do
any
4
of
the
following:
5
a.
Make
decisions
regarding
the
patient’s
care
facility
6
placement.
7
b.
Assist
the
patient
in
applying
for
health
insurance
8
coverage
through
a
private
insurer,
or
applying
for
a
public
9
assistance
program,
as
necessary
to
facilitate
the
patient’s
10
care
facility
placement.
11
c.
Take
any
other
action
expressly
authorized
by
the
12
patient.
13
2.
A
person
authorized
to
consent
shall
act
in
good
faith
14
and
must
consider
all
of
the
following:
15
a.
The
patient’s
wishes,
if
known.
16
b.
The
patient’s
rights.
17
c.
The
best
interests
of
the
patient.
18
3.
A
person
authorized
to
consent
may,
as
reasonably
19
necessary
to
assist
the
patient
in
applying
for
health
20
insurance
coverage
through
a
private
insurer,
or
applying
for
a
21
public
assistance
program,
do
any
of
the
following:
22
a.
Access
the
patient’s
banking
and
other
financial
records
23
as
permitted
by
state
and
federal
law.
This
paragraph
shall
24
not
be
construed
to
permit
the
person
authorized
to
consent
to
25
own,
manage,
use,
or
dispose
of
any
of
the
patient’s
financial
26
resources
without
the
patient’s
express
consent.
27
b.
Disclose
the
patient’s
relevant
health
information
to
28
a
third
party.
The
person
authorized
to
consent
shall
not
29
disclose
a
patient’s
protected
health
information
in
violation
30
of
the
federal
Health
Insurance
Portability
and
Accountability
31
Act
of
1996,
Pub.
L.
No.
104-191.
32
4.
The
authority
of
a
person
authorized
to
consent
shall
33
expire
upon
the
earliest
of
any
of
the
following:
34
a.
The
date
that
the
patient’s
care
facility
placement
35
-3-
LSB
5341SV
(2)
91
ak/ko
3/
11
S.F.
2423
as
decided
by
the
person
authorized
to
consent
is
completed,
1
and
notice
of
approval
or
denial
of
an
application
for
health
2
insurance
coverage
through
a
private
insurer,
or
for
a
public
3
assistance
program,
if
applicable,
is
received
by
a
qualified
4
employee
of
the
receiving
care
facility.
5
b.
An
authorized
representative,
or
a
person
authorized
to
6
consent
who
has
higher
priority,
has
been
located.
7
Sec.
4.
NEW
SECTION
.
144H.4
Care
facility
——
duties.
8
1.
A
social
worker,
discharge
planner,
or
other
qualified
9
employee
as
designated
by
a
patient’s
current
care
facility
10
shall
do
all
of
the
following
with
respect
to
a
person
11
authorized
to
consent:
12
a.
Inform
the
person
of
the
person’s
powers
and
duties
13
pursuant
to
this
chapter.
14
b.
Assist
the
person
with
identifying
a
receiving
care
15
facility
for
the
patient
that
can
provide
the
least
restrictive
16
and
appropriate
level
of
care,
as
recommended
by
the
physician
17
under
section
144H.2,
for
the
patient
and
consented
to
by
a
18
social
worker,
intake
coordinator,
or
other
qualified
employee
19
of
the
receiving
care
facility.
20
2.
If
a
receiving
care
facility
for
the
patient
that
can
21
provide
the
least
restrictive
and
appropriate
level
of
care
as
22
described
under
subsection
1
is
identified,
and
the
receiving
23
care
facility
consents,
the
patient
shall
be
transferred
to
the
24
receiving
care
facility.
25
Sec.
5.
NEW
SECTION
.
144H.5
Petition
for
court
order.
26
1.
After
good-faith
efforts
to
locate
an
authorized
27
representative
for
the
patient
or
a
person
authorized
to
28
consent,
a
care
facility
or
attending
physician
may
petition
a
29
court
of
competent
jurisdiction
to
order
any
of
the
following:
30
a.
The
patient’s
care
facility
placement.
31
b.
The
patient’s
attending
physician
or
a
social
worker,
32
intake
worker,
or
other
qualified
employee
of
the
receiving
33
care
facility
to
assist
the
patient
to
apply
for
health
34
insurance
coverage
through
a
private
insurer
or
apply
for
a
35
-4-
LSB
5341SV
(2)
91
ak/ko
4/
11
S.F.
2423
public
assistance
program,
if
appropriate.
1
2.
The
petition
made
must
include
the
following
2
information:
3
a.
The
name,
age,
and
address
where
the
patient
resides,
if
4
known
to
the
petitioner.
5
b.
The
name,
address,
and
county
of
residence
of
the
6
petitioner.
7
c.
The
relationship
of
the
petitioner
to
the
patient.
8
d.
The
address
where
the
patient
can
be
found,
if
different
9
from
the
patient’s
residential
address.
10
e.
A
physician’s
certification
pursuant
to
section
144H.2.
11
f.
An
affidavit
from
the
patient’s
attending
physician,
12
that
upon
an
examination
of
the
patient
and
consultation
with
13
another
health
care
provider,
all
of
the
following
are
true:
14
(1)
The
patient
is
not
able
to
consent.
15
(2)
The
patient
has
not
identified,
and
despite
good-faith
16
efforts
the
attending
physician
has
been
unable
to
locate,
an
17
authorized
representative
or
a
person
authorized
to
consent.
18
(3)
The
receiving
care
facility
placement
recommended
by
19
the
attending
physician
is
in
the
patient’s
best
interests.
20
(4)
The
receiving
care
facility
placement
recommended
by
21
the
attending
physician
will
provide
the
least
restrictive
and
22
most
appropriate
level
of
care
for
the
patient,
and
is
within
a
23
reasonable
proximity
to
the
patient’s
residence,
if
applicable.
24
g.
An
affidavit
from
a
social
worker,
discharge
planner,
or
25
other
qualified
employee
as
designated
by
the
patient’s
current
26
care
facility
attesting
to
all
of
the
following:
27
(1)
The
patient
has
not
identified,
and
despite
good-faith
28
efforts
the
current
care
facility
has
been
unable
to
locate,
an
29
authorized
representative
or
a
person
authorized
to
consent.
30
(2)
The
receiving
care
facility
placement
recommended
by
31
the
attending
physician
will
provide
the
least
restrictive
and
32
most
appropriate
level
of
care
for
the
patient.
33
(3)
Other
care
facilities
within
a
reasonable
proximity
34
to
the
patient’s
residence
were
considered
for
placement,
if
35
-5-
LSB
5341SV
(2)
91
ak/ko
5/
11
S.F.
2423
applicable.
1
h.
An
affidavit
from
a
social
worker,
intake
coordinator,
2
or
other
qualified
employee
of
the
receiving
care
facility
3
recommended
by
the
patient’s
attending
physician
attesting
to
4
all
of
the
following:
5
(1)
The
receiving
care
facility
is
the
most
appropriate
6
facility
available
for
the
patient.
7
(2)
The
receiving
care
facility
can
provide
the
least
8
restrictive
and
most
appropriate
level
of
care
to
the
patient.
9
(3)
The
receiving
care
facility
consents
to
the
transfer
or
10
admission
of
the
patient.
11
i.
The
name
and
address
of
the
receiving
care
facility
12
recommended
by
the
attending
physician.
13
3.
The
court
may
grant
the
petition
if
the
court
finds
all
14
of
the
following:
15
a.
The
patient
is
not
able
to
consent.
16
b.
Despite
good-faith
efforts
by
the
attending
physician
17
and
the
patient’s
current
care
facility,
an
authorized
18
representative
or
person
authorized
to
consent
has
not
been
19
located.
20
c.
Placement
in
the
receiving
care
facility
recommended
21
by
the
patient’s
attending
physician
is
in
the
patient’s
best
22
interest.
23
d.
Placement
in
the
receiving
care
facility
recommended
24
by
the
patient’s
attending
physician
will
provide
the
least
25
restrictive
and
most
appropriate
level
of
care
for
the
patient.
26
e.
A
social
worker,
intake
coordinator,
or
other
qualified
27
employee
of
the
receiving
care
facility
recommended
by
the
28
patient’s
attending
physician
has
consented
to
the
admission
29
of
the
patient.
30
4.
If
the
court
grants
the
petition
under
subsection
3,
the
31
court
shall
also
order,
if
necessary,
that
a
qualified
employee
32
of
the
receiving
care
facility
has
the
authority
to
apply
for
a
33
public
assistance
program
on
the
patient’s
behalf.
34
5.
An
order
authorizing
placement
pursuant
to
this
section
35
-6-
LSB
5341SV
(2)
91
ak/ko
6/
11
S.F.
2423
shall
remain
in
effect
until
the
earliest
of
any
of
the
1
following:
2
a.
A
date
specified
by
the
court
not
to
exceed
thirty
3
calendar
days
from
the
date
of
issuance
of
the
order.
4
b.
The
date
the
patient’s
placement
in
the
receiving
care
5
facility
as
ordered
by
the
court
is
completed.
6
c.
The
date
an
attending
physician
certifies
that
the
7
patient
is
able
to
consent
to
the
patient’s
placement
in
the
8
receiving
care
facility.
9
6.
An
order
authorizing
a
qualified
employee
of
a
receiving
10
facility
to
apply
for
a
public
assistance
program
on
a
11
patient’s
behalf
pursuant
to
this
section
shall
remain
in
12
effect
until
the
earliest
of
any
of
the
following:
13
a.
A
date
specified
by
the
court.
14
b.
Notice
of
approval
or
denial
of
an
application
for
health
15
insurance
coverage
through
a
private
insurer,
or
for
a
public
16
assistance
program
is
received
by
a
qualified
employee
of
the
17
receiving
facility.
18
c.
The
date
that
an
attending
physician
certifies
that
the
19
patient
is
able
to
consent
to
the
application
for
a
public
20
assistance
program.
21
Sec.
6.
NEW
SECTION
.
144H.6
Immunity
——
liability
and
22
professional
discipline.
23
1.
A
person
or
care
facility
acting
in
good
faith
pursuant
24
to
this
chapter
shall
not
be
subject
to
civil
or
criminal
25
liability.
26
2.
A
licensee
under
chapter
148
acting
reasonably
and
in
27
good
faith
pursuant
to
this
chapter
shall
not
be
subject
to
28
licensee
discipline.
29
Sec.
7.
NEW
SECTION
.
144H.7
Construction.
30
This
chapter
shall
not
be
construed
to
do
any
of
the
31
following:
32
1.
Require
a
care
facility
to
accept
the
transfer
or
33
admission
of
a
patient.
34
2.
Repeal,
abrogate,
or
impair
the
operation
of
any
other
35
-7-
LSB
5341SV
(2)
91
ak/ko
7/
11
S.F.
2423
federal
or
state
laws
governing
the
transfer,
admission,
or
1
discharge
of
a
patient
to
or
from
a
care
facility.
2
3.
Infringe
upon
the
rights
of
a
patient
under
federal
or
3
state
law
relating
to
the
involuntary
transfer,
admission,
or
4
discharge
to
or
from
a
care
facility.
5
Sec.
8.
NEW
SECTION
.
144H.8
Rules.
6
The
department
may
promulgate
rules
pursuant
to
chapter
17A
7
as
necessary
to
administer
this
chapter.
8
EXPLANATION
9
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
10
the
explanation’s
substance
by
the
members
of
the
general
assembly.
11
This
bill
relates
to
care
facility
placement
decisions
for
12
certain
adults.
13
The
bill
defines
“authorized
representative”
as
an
agent,
14
attorney
in
fact,
conservator,
or
guardian.
“Person
authorized
15
to
consent”
(authorized
person)
is
defined
as
a
member
of
any
16
of
the
following
groups
of
individuals,
in
order
of
priority,
17
that
is
willing
and
able
to
consent,
refuse
to
consent,
or
18
withdraw
consent
on
a
patient’s
behalf:
the
patient’s
spouse,
19
the
adult
children,
the
parent
or
parents
of
a
patient,
or
the
20
adult
siblings
of
the
patient.
“Care
facility”
is
defined
as
21
a
facility
that
provides
a
patient
with
health-related
and
22
personal
care
services,
including
a
hospital,
medical
clinic,
23
nursing
facility,
rehabilitation
facility,
or
residential
care
24
facility.
“Placement”
is
defined
as
the
admission,
discharge,
25
or
transfer
of
a
patient.
26
The
bill
provides
that
a
physician
licensed
under
the
laws
27
of
this
state
may
certify
in
a
patient’s
record
that
the
28
patient
is
not
able
to
consent,
an
authorized
representative
29
for
the
patient
has
not
been
located
by
the
physician
despite
30
good-faith
efforts,
and
that
it
is
in
the
patient’s
best
31
interests
to
be
discharged
from
the
patient’s
current
care
32
facility
and
transferred
or
admitted
to
a
care
facility
33
recommended
by
the
physician.
“Patient”
and
“able
to
consent”
34
are
defined
in
the
bill.
35
-8-
LSB
5341SV
(2)
91
ak/ko
8/
11
S.F.
2423
The
bill
provides
that
an
authorized
person
shall
act
in
1
good
faith
and
consider
the
patient’s
rights,
wishes,
and
best
2
interests.
The
bill
authorizes
the
authorized
person,
upon
3
the
physician’s
certification,
to
make
care
facility
placement
4
decisions
and
assist
the
patient
in
applying
for
health
5
insurance
coverage
through
private
insurance,
or
for
a
public
6
assistance
program,
as
necessary
to
facilitate
placement.
The
7
bill
allows
the
authorized
person,
as
reasonably
necessary
to
8
assist
the
patient
in
applying
for
health
insurance
coverage
9
through
a
private
insurer
or
a
public
assistance
program
and
as
10
permitted
under
state
and
federal
law,
to
access
a
patient’s
11
financial
and
banking
records
as
well
as
disclose
relevant
12
health
information
to
a
third
party.
13
The
bill
provides
that
the
authority
of
an
authorized
person
14
expires
when
the
placement
decided
by
the
authorized
person
is
15
completed
and
notice
of
approval
or
denial
of
an
application
16
for
health
insurance
coverage
through
a
private
insurer,
or
17
for
a
public
assistance
program,
if
applicable,
is
received
by
18
a
qualified
employee
of
the
receiving
care
facility,
or
when
19
an
authorized
representative
or
authorized
person
of
higher
20
priority
is
located.
21
The
bill
requires
a
social
worker,
discharge
planner,
or
22
other
qualified
employee
as
designated
by
the
current
care
23
facility
of
the
patient
to
inform
an
authorized
person
of
24
the
person’s
powers
and
duties
and
to
assist
the
person
with
25
identifying
a
receiving
care
facility
for
the
patient
that
will
26
provide
the
least
restrictive
and
appropriate
level
of
care
for
27
the
patient
as
recommended
by
the
certifying
physician.
If
the
28
receiving
care
facility
as
described
in
the
bill
is
identified
29
and
consents,
the
patient
shall
be
transferred
to
the
receiving
30
care
facility.
31
After
a
good-faith
effort
to
locate
an
authorized
32
representative
or
authorized
person,
the
bill
allows
an
33
attending
physician
or
a
care
facility
to
petition
a
court
of
34
competent
jurisdiction
to
order
placement
or
that
a
patient’s
35
-9-
LSB
5341SV
(2)
91
ak/ko
9/
11
S.F.
2423
attending
physician
or
a
social
worker,
intake
worker,
or
1
other
qualified
employee
of
the
receiving
care
facility
2
assist
the
patient
in
applying
for
health
insurance
coverage
3
through
a
private
insurer
or
a
public
assistance
program.
The
4
petition
must
include
certain
information
about
the
patient,
5
the
petitioner,
the
current
care
facility,
and
the
proposed
6
receiving
care
facility,
and
be
supported
by
affidavits
from
7
an
attending
physician,
a
social
worker,
intake
coordinator,
8
discharge
planner,
or
other
qualified
employee
from
both
the
9
current
and
the
proposed
receiving
care
facility.
The
bill
10
allows
the
court
to
grant
the
petition
if
it
finds
that
the
11
patient
is
not
able
to
consent,
no
authorized
representative
12
for
the
patient
or
authorized
person
has
been
located
by
the
13
attending
physician
and
the
patient’s
current
care
facility
14
despite
good-faith
efforts,
placement
in
the
receiving
care
15
facility
recommended
to
the
court
by
the
patient’s
attending
16
physician
is
in
the
best
interests
of
the
patient,
and
will
17
provide
the
least
restrictive
and
most
appropriate
level
of
18
care
for
the
patient.
A
social
worker,
intake
coordinator,
19
or
other
qualified
employee
of
the
proposed
receiving
care
20
facility
must
consent
to
the
admission
of
the
patient.
If
a
21
court
order
authorizes
a
patient’s
transfer
to
the
receiving
22
care
facility,
the
authority,
if
necessary,
to
apply
for
23
a
public
assistance
program
on
the
patient’s
behalf
shall
24
transfer
pursuant
to
court
order
to
a
qualified
employee
of
the
25
receiving
care
facility.
26
The
bill
provides
that
the
court’s
order
shall
be
effective
27
until
a
date
specified
by
the
court
not
to
exceed
30
calendar
28
days
from
the
date
of
the
issuance
of
the
order,
the
completion
29
of
any
placement
of
the
patient
in
the
receiving
care
facility
30
as
ordered,
or
the
date
that
a
physician
certifies
that
the
31
patient
is
able
to
consent
to
the
patient’s
placement
in
a
care
32
facility.
33
The
bill
provides
that
a
court
order
authorizing
a
qualified
34
employee
of
a
receiving
facility
to
apply
for
a
public
35
-10-
LSB
5341SV
(2)
91
ak/ko
10/
11
S.F.
2423
assistance
program
on
a
patient’s
behalf
shall
be
effective
1
until
a
date
specified
by
the
court,
the
date
notice
of
2
approval
or
denial
of
an
application
for
health
insurance
3
coverage
through
a
private
insurer,
or
for
a
public
assistance
4
program
is
received
by
a
qualified
employee
of
the
receiving
5
facility,
or
the
date
that
an
attending
physician
certifies
6
that
the
patient
is
able
to
consent
to
the
application
for
a
7
public
assistance
program.
8
The
bill
provides
immunity
from
civil
or
criminal
liability
9
to
a
person
or
care
facility
acting
in
good
faith
under
the
10
bill.
Immunity
from
licensee
discipline
is
also
provided
for
11
licensees
acting
reasonably
and
in
good
faith.
12
The
bill
is
not
to
be
construed
to
require
a
health
care
13
facility
to
accept
the
transfer
or
admission
of
a
patient;
to
14
repeal,
abrogate,
or
impair
the
operation
of
any
other
federal
15
or
state
laws
governing
the
transfer,
admission,
or
discharge
16
of
a
patient
to
or
from
a
care
facility;
or
to
infringe
upon
17
the
rights
of
patients
under
federal
or
state
law
relating
to
18
the
involuntary
transfer,
admission,
or
discharge
to
or
from
a
19
care
facility.
20
The
bill
authorizes
the
department
of
health
and
human
21
services
to
adopt
rules
to
administer
the
bill.
22
-11-
LSB
5341SV
(2)
91
ak/ko
11/
11