All Roll Calls
Yes: 223 • No: 0
IowaHF 256291st General Assembly (2025–2026)House
A bill for an act relating to care facility placement decisions for certain adults, and including effective date provisions. (Formerly HSB 653.) Effective Date: Conditional, 07/01/2026.
Sponsored By: COMMITTEE ON HEALTH AND HUMAN SERVICES
Signed by Governor
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Bill Overview
Analyzed Economic Effects
3 provisions identified: 3 benefits, 0 costs, 0 mixed.
Families can arrange care for incapacitated adults
Beginning July 1, 2026, Iowa gives eligible decision-makers authority to arrange care-facility admission, discharge, or transfer for adults who cannot consent. A physician must certify that the patient cannot consent, no appointed representative was found despite good-faith efforts, and the recommended placement serves the patient’s best interests. Priority starts with a spouse, then adult children, parents, and adult siblings, with majority-agreement rules for available children or siblings. Lower-priority relatives and close friends may also qualify under the statutory order. Decision-makers must be available and willing, act in good faith, and consider the patient’s known wishes, rights, and best interests. They can help with private insurance and public benefits, including Medicaid and Medicare, and access needed financial records and health information as the law allows. They cannot own, manage, or dispose of the patient’s resources without express consent. Their authority ends when placement is complete and receiving staff get the coverage application results, or sooner when a representative or higher-priority decision-maker is found. A separate priority update takes effect only if House File 2305 or a successor makes substantially similar changes to Iowa’s patient decision-making law. That update requires decision-makers to follow the patient’s expressed or implied wishes and be available, willing, and competent.
Placement help for adults without decision-makers
Beginning July 1, 2026, facility staff must explain substitute decision-makers’ duties and help find suitable care after the required physician certification. Placement must match the recommended care level, use the least restrictive setting, and be reasonably near the patient’s home. A suitable receiving facility must agree to accept the patient before transfer. When good-faith searches find neither an appointed representative nor an eligible substitute, the facility or attending doctor can petition a court. The court can approve placement after finding that the patient cannot consent and that these placement safeguards are met. It can also authorize facility staff to apply for private insurance or public benefits on the patient’s behalf. A placement order ends at the earliest of the court’s deadline, no more than 30 days, completed placement, or physician certification that consent capacity has returned. Application authority ends at the court’s deadline, notice of approval or denial, or the patient regaining the ability to consent. Doctors must send incapacity certifications to Iowa’s Division of Aging and Disability Services. Facilities or doctors must send petition copies at least 10 days before filing; courts must send granted orders, and receiving facilities must report completed placements. Facilities do not have to accept transfers, and other admission laws and patient rights remain in place.
Legal protection for good-faith care decisions
Beginning July 1, 2026, people and care facilities acting in good faith under this placement law receive civil and criminal liability protection. Physicians licensed under Iowa Code chapter 148 also receive protection from professional discipline when acting reasonably and in good faith. These protections apply to actions under this law, not all care decisions. They do not provide patients a direct payment.
Sponsors & Cosponsors
Sponsor
COMMITTEE ON HEALTH AND HUMAN SERVICES
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
House vote • 4/22/2026
Passed House
Yes: 89 • No: 0
Senate vote • 4/20/2026
Passed Senate
Yes: 44 • No: 0
House vote • 2/26/2026
Passed House
Yes: 90 • No: 0
Actions Timeline
Signed by Governor.
5/15/2026HouseFiscal note.
5/14/2026legislatureReported correctly enrolled, signed by Speaker and President, and sent to Governor.
5/6/2026HouseExplanation of vote.
5/1/2026HouseMessage from House.
4/22/2026SenateImmediate message.
4/22/2026HousePassed House, yeas 89, nays 0.
4/22/2026HouseHouse concurred in Senate amendment H-8387.
4/22/2026HouseFiscal note.
4/21/2026legislatureSenate amendment H-8387 filed.
4/20/2026HouseMessage from Senate.
4/20/2026HouseImmediate message.
4/20/2026SenatePassed Senate, yeas 44, nays 0.
4/20/2026SenateAmendment S-5184 out of order.
4/20/2026SenateAmendment S-5195 filed, adopted.
4/20/2026SenateSubstituted for SF 2423.
4/20/2026SenateAmendment S-5184 filed.
4/15/2026SenatePlaced on calendar under unfinished business.
3/19/2026SenateRead first time, attached to SF 2423.
3/2/2026SenateMessage from House.
3/2/2026SenateImmediate message.
2/26/2026HousePassed House, yeas 90, nays 0.
2/26/2026HouseAmendment H-8044 adopted.
2/26/2026HouseFiscal note.
2/26/2026legislatureAmendment H-8044 filed.
2/25/2026House
Bill Text
As Introduced
Enrolled
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