Iowa law sets a process for placing adults who cannot consent

A doctor may certify that an adult cannot consent, no authorized representative has been found, and a move is in the patient’s best interests. A person in the listed priority order may then make placement decisions. These rules cover adults receiving health or personal care services from a hospital, clinic, nursing facility, rehabilitation facility, or residential care facility. The decision-maker must act in good faith and consider the patient’s known wishes, rights, and best interests. A care facility employee must help identify a suitable receiving facility, and that facility must agree to accept the patient. For insurance or public assistance applications, the decision-maker may access financial records as allowed by law and share relevant health information, but may not use the patient’s money without express consent. The decision-maker’s authority ends when placement is complete and any related insurance decision is received, or when an authorized representative or higher-priority decision-maker is found.

A care facility or attending doctor may ask a court to approve placement and, if needed, let a receiving facility employee apply for public assistance for the patient. This process applies to adults receiving care facility services when no authorized representative or listed decision-maker can be found. The court may approve placement only after good-faith efforts to find an authorized representative or listed decision-maker. It must find that the patient cannot consent, the placement is in the patient’s best interests, and the facility can provide suitable care in the least restrictive setting. The receiving facility must agree to accept the patient. The court may also authorize an employee to apply for public assistance. A placement order ends on the court’s stated date, no later than 30 days after it is issued, when placement is completed, or when a doctor certifies that the patient can consent.

If the specified related legislation takes effect, the decision-maker priority list includes other adult relatives and a close adult friend after the listed family members. The conditional list applies when the patient does not have an attorney in fact or one of the guardians described in the conditional language. This division takes effect only if House File 2305, or successor legislation, makes the specified substantially similar change to Iowa Code section 144A.7. This division takes effect only if the condition in section 11 is met.