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Read. Follow. Verify.Iowa establishes care facility placement decision rules for adults unable to consent
Last action · May 15, 2026: Signed by Governor . H.J. 1167 .
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What This Bill Does
Senate File 2423 establishes a legal framework allowing physicians, family priority lists, or courts to make care facility admission, discharge, and transfer decisions for adults who are unable to consent and lack an . The measure outlines duties for care facilities, grants qualified individuals authority to apply for health coverage on the patient's behalf, and provides civil and criminal immunity for acting in good faith.
Establishes a structured decision-making protocol for vulnerable adult patients without legal representatives, impacting how hospitals, nursing facilities, and residential care facilities handle emergency or routine placement transfers.
- Senate File 2423 originated as Senate Study Bill 3096 from the Committee on Health and Human Services during the 91st General Assembly of Iowa. context
Who It Affects
Groups the bill's text affects, as described in the record. Being affected is not a position for or against it.
Adult patients unable to consent
Their care facility placement, health insurance applications, and medical information disclosure can be managed by surrogate decision-makers or court orders.
Care facilities
Hospitals, nursing facilities, and residential care facilities must follow certification, assistance, and transfer protocols and receive immunity when acting in good faith.
Attending physicians
Licensed physicians are empowered to certify a patient's inability to consent and recommend receiving care facilities or petition courts.
Key Facts
- Defines 'person authorized to consent' in priority order as the patient's spouse, adult children, parents, or adult siblings when a patient is unable to consent and no authorized representative is found.
- Allows a licensed physician to certify in a patient's medical records that the patient cannot consent, no representative is located, and transfer to a recommended care facility is in the patient's best interests.
- Grants authorized persons the power to make care facility placement decisions and assist the patient in applying for private health insurance or public assistance programs.
- Permits authorized persons to access banking and financial records as necessary for insurance applications without gaining management or ownership rights over the resources.
Show all 9 facts
- Requires current care facility social workers or discharge planners to inform authorized persons of their powers and assist in identifying a receiving facility providing the least restrictive and appropriate level of care.
- Allows care facilities or attending physicians to petition a court for an order authorizing placement and public assistance applications if no authorized representative can be located.
- Limits court placement orders to a maximum of 30 calendar days from the date of issuance or until placement is completed or the patient regains capacity to consent.
- Provides civil and criminal immunity for persons and care facilities acting in good faith under the chapter, and protects medical licensees from professional discipline if acting reasonably.
- Authorizes the Department of Health and Human Services to promulgate administrative rules to administer the chapter.
Frequently Asked Questions
Who can make care facility decisions if a patient is unable to consent and has no legal guardian?
What happens if no family members can be located to make a placement decision?
Can an authorized person take control of a patient's bank accounts?
How long does a court-ordered placement remain in effect?
What else do you want to know?
News Coverage
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Votes, people, money & the original sourceWhere This Stands
Current status: Signed into law.
Procedural history
47 actions- May 15, 2026HouseEnrolledSigned by Governor . H.J. 1167 .
- May 14, 2026Iowa LegislatureFiscal note.
- May 6, 2026HouseReported correctly enrolled, signed by Speaker and President, and sent to Governor. H.J. 1164 .
- May 1, 2026HouseExplanation of vote. H.J. 1082 .
- Apr 22, 2026HouseMessage from House. S.J. 877 .
- Apr 22, 2026HouseImmediate message. H.J. 985 .
Show 41 earlier actions
- Apr 22, 2026HouseFloorPassed House , yeas 89, nays 0. H.J. 981 .
- Apr 22, 2026HouseFloorHouse concurred in Senate amendment H-8387 . H.J. 981 .
- Apr 21, 2026Iowa LegislatureFiscal note.
- Apr 20, 2026HouseSenate amendment H-8387 filed. H.J. 953 .
- Apr 20, 2026HouseMessage from Senate. H.J. 948 .
- Apr 20, 2026SenateImmediate message. S.J. 835 .
- Apr 20, 2026SenateFloorPassed Senate , yeas 44, nays 0. S.J. 832 .
- Apr 20, 2026SenateAmendment S-5184 out of order. S.J. 832 .
- Apr 20, 2026SenateFloorAmendment S-5195 filed, adopted. S.J. 832 .
- Apr 20, 2026SenateSubstituted for SF 2423 . S.J. 831 .
- Apr 20, 2026SenateWithdrawn. S.J. 833 .
- Apr 20, 2026SenateHF 2562 substituted. S.J. 831 .
- Apr 20, 2026SenateFloorAmendment S-5048 adopted. S.J. 831 .
- Apr 15, 2026SenateAmendment S-5184 filed. S.J. 811 .
- Mar 19, 2026SenatePlaced on calendar under unfinished business. S.J. 600 .
- Mar 19, 2026SenatePlaced on calendar under unfinished business. S.J. 600 .
- Mar 5, 2026Iowa LegislatureFiscal note .
- Mar 2, 2026SenateIntroducedRead first time, attached to SF 2423 . S.J. 423 .
- Mar 2, 2026HouseMessage from House. S.J. 423 .
- Mar 2, 2026SenateAmendment S-5048 filed. S.J. 437 .
- Mar 2, 2026SenateAttached to HF 2562 . S.J. 423 .
- Feb 26, 2026HouseImmediate message. H.J. 460 .
- Feb 26, 2026HouseFloorPassed House , yeas 90, nays 0. H.J. 452 .
- Feb 26, 2026HouseFloorAmendment H-8044 adopted. H.J. 452 .
- Feb 26, 2026Iowa LegislatureFiscal note.
- Feb 25, 2026HouseAmendment H-8044 filed. H.J. 436 .
- Feb 23, 2026SenateCommittee report, approving bill. S.J. 367 .
- Feb 23, 2026SenateIntroducedIntroduced, placed on calendar. S.J. 355 .
- Feb 17, 2026Iowa LegislatureCommittee report approving bill, renumbered as SF 2423 .
- Feb 16, 2026HouseIntroducedIntroduced, placed on calendar. H.J. 308 .
- Feb 16, 2026Iowa LegislatureCommittee report approving bill, renumbered as HF 2562 .
- Feb 12, 2026HouseCommittee vote: Yeas, 13. Nays, 7. Excused, 1. H.J. 283 .
- Feb 12, 2026HouseCommittee report, recommending amendment and passage. H.J. 283 .
- Feb 5, 2026Iowa LegislatureSubcommittee recommends passage.
- Feb 4, 2026Iowa LegislatureSubcommittee Meeting: 02/05/2026 8:30AM RM 19.
- Feb 4, 2026Iowa LegislatureSubcommittee recommends amendment and passage.
- Feb 3, 2026HouseSubcommittee: Ingels, Ehlert and Gehlbach. H.J. 197 .
- Feb 3, 2026HouseIntroducedIntroduced, referred to Health and Human Services. H.J. 195 .
- Feb 3, 2026Iowa LegislatureSubcommittee Meeting: 02/04/2026 2:00PM Room 315.
- Jan 29, 2026Iowa LegislatureSubcommittee: Costello, Salmon, and Trone Garriott.
- Jan 29, 2026Iowa LegislatureIntroducedIntroduced, referred to Health and Human Services.
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Creation of New Statutory Chapter 144H
The bill creates an entirely new chapter in Iowa law governing care facility placement decisions and surrogate consent for adults unable to consent.
Connected Entities
Sources
www.legis.iowa.gov
Analysis Score
0–100- Significance75How much this matters to a regular citizen
- Controversy25Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz20Current news / social attention level
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