WeVote
Log In

Bill

Bill

HF 2305

A bill for an act relating to health care decisions related to palliative care, hospice programs, life-sustaining procedures, out-of-hospital do-not-resuscitate orders, durable power of attorney for health care, and probate court guardianship reports.

2025-2026 Regular Session

The bill standardizes decision-making for incapacitated patients by clarifying who can authorize hospice, DNR, and life-sustaining care, prioritizing patient wishes and expanding e

Signed by Governor.
#affidavits #health #healthandhumanservicesdepartment #hospiceservices #lifesupport #medicalcare #out-of-hospitaldo-not-resuscitateorders #powerofattorney #probatecode #terminalillnesses
0
WeVote Research Nonpartisan
Bill Summary · HF 2305

Summary of HF 2305 (2025-2026) – Iowa

A bill relating to health care decisions involving palliative care, hospice programs, life-sustaining procedures, out-of-hospital do-not-resuscitate orders, and durable power of attorney for health care, with amendments to guardianship, decision-making priority, and related provisions.

Note: This summary reflects the amended version as reflected in the latest committee amendment (S-5122) and subsequent referenced changes.

1) Purpose and Intent

  • Streamline and clarify decision-making for health care when a patient cannot make decisions for themselves.
  • Align processes for hospice enrollment, life-sustaining treatments, and do-not-resuscitate (DNR) decisions with patient preferences and legally recognized representatives.
  • Integrate durable power of attorney for health care (DPOA-HC) and guardian roles into a unified decision-making framework, particularly in hospital, long-term care, and other health care facility settings.
  • Add or clarify evaluation of a patient’s wishes in the context of terminal illness, hospice placement, and withholding/withdrawing life-sustaining procedures.

2) Key Provisions and Changes

  • Admission to Hospice
    • Clarifies who may request and receive admission to a hospice program on behalf of a patient.
    • If the patient cannot request admission, a specified surrogate may request admission on the patient’s behalf:
    • Family member
    • The patient’s attorney in fact (as defined in section 144B.1)
    • The patient’s guardian appointed under chapter 633 (or the majority of guardians if more than one with equal responsibilities)
  • Decision-Making for Health Care
    • Establishes a priority order for who may make health care decisions when a patient lacks capacity, with guidance by the patient’s express or implied intentions.
    • Adds explicit constraints: a guardian under chapter 232D is not subject to the same provisions in certain respects (as indicated by the text).
    • Adds definitions for relevant roles:
    • Attorney in fact (under a durable power of attorney for health care)
    • Close adult friend (criteria include age, demonstrated care, regular contact, and an affidavit affirming willingness and ability to be involved in care)
    • Durable power of attorney for health care (authorization to make health care decisions when the patient cannot)
  • Scope of Application
    • Limits certain sections to patients located in health care facilities or health facilities (as defined by Iowa law).
  • Decision-Making in Absence of a DPOA or Guardian
    • If the patient has no attorney in fact or guardian, a designated individual (per the priority order in section 144A.7, subsection 1) may make decisions guided by the patient’s wishes, provided they are reasonably available, willing, and competent.
    • If a majority of guardians with equal responsibilities cannot reach consensus, a court order is required.
  • Hospice and Terminal Condition Considerations
    • Adds new statutory subparagraphs to 633.669 (Code 2026) addressing:
    • The protected person’s wishes related to withholding or withdrawal of life-sustaining procedures (under chapters 144A or 144D)
    • The protected person’s wishes related to placement in a hospice program in the event of a terminal condition
  • Out-of-Hospital DNR and Probate-Related References
    • Revisions to include alignment with out-of-hospital do-not-resuscitate orders and related probate court guardianship reports (as reflected in the revised title and sections).

3) Who/What is Affected

  • Patients in health care facilities or health facilities within Iowa (as defined by statute).
  • Individuals who may serve as:
    • Durable power of attorney for health care (DPOA-HC)
    • Attorney in fact under a durable power of attorney
    • Guardians appointed under chapter 633 (and guardians with equal responsibilities)
    • Close adult friends who may be involved in patient care (with a defined affidavit)
  • Hospice programs and admission processes
  • Health care providers and attending physicians responsible for implementing patient wishes
  • Courts, when guardian consensus cannot be achieved (requiring a court order)

4) Procedural and Timeline Aspects

  • The amendment process includes several steps, with House action and committee amendments (notably amendments S-5122 and related filings).
  • The bill includes explicit effective-related references to 2026 for certain Code amendments (e.g., 633.669 changes), indicating phased or future applicability as part of codification.
  • If guardians cannot reach a majority decision on a patient’s care, a court order is required.
  • The bill specifies that the decision-making framework applies to patients located in health care facilities for certain provisions, limiting or clarifying applicability.

5) Practical Implications

  • Potentially faster and clearer access to hospice enrollment when the patient cannot request it themselves, using a defined hierarchy of authorized surrogates.
  • More explicit recognition of a broader set of decision-makers (including close adult friends under defined criteria) in the absence of a DPOA or guardian.
  • Greater emphasis on honoring the patient’s stated or implied wishes regarding life-sustaining treatment and hospice placement.
  • Increased role for guardians and potential for court involvement if consensus among guardians cannot be achieved.

If you’d like, I can tailor this summary to a specific audience (e.g., policymakers, health care providers, or patient advocates) or add a comparison with current Iowa law.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.