Bills › 90th General Assembly
Where it is now
- Done: IntroducedFebruary 6, 2024
- Done: SubcommitteeFebruary 6, 2024
- Done: House committeeFebruary 14, 2024
- Skipped: Passes the HouseContinued as HF 2577
- Next: Senate committee
- Next: Passes the Senate
- Next: To the Governor
- Next: Signed into law
Became HF 2577 → Its progress continues under the new number. Go to HF 2577 What’s a funnel?
What’s in it
AI summary Guardians who look after adults would gain the power to make end-of-life medical decisions, such as choosing hospice care or deciding whether to use life-sustaining treatments. Before making these choices, a guardian must talk to the person they are helping or, if that person cannot communicate, talk to their family and close friends. Unless the person is terminally ill, the guardian must also get permission from a judge before they can stop life-sustaining procedures or allow medicine that ends a person's life.1
Read the official explanation
This bill relates to end-of-life care decisions under guardianships of adults. _____ ability to make decisions regarding the care, maintenance, health, education, welfare, and safety of the protected person except as otherwise limited by the court, which the guardian may exercise thereafter without prior court approval. The bill provides that this includes end-of-life care decisions (hospice, palliative care, and life-sustaining interventions, and the power to execute, reaffirm, or revoke a do-not-resuscitate or do-not-intubate order). A guardian is only able to make an end-of-life care decision if the guardian has consulted with the protected person not more than days before executing the end-of-life care decision and consulted with the protected person’s attending physician. However, if the protected person is not able to have a meaningful conversation about end-of-life care decisions, a guardian may instead consult with family members and other significant others of the protected person not more than days before executing the end-of-life decision. The bill provides that except for cases in which the protected person’s diagnosis is a terminal illness with life expectancy of six months or less, a guardian may not authorize the withdrawal of life-sustaining procedures or authorize any medicine or procedure that terminates the protected person’s life without first obtaining a court order authorizing such action.
House subcommittee
Named February 6, 2024. On February 7, 2024 it recommended passage. Vote Total: 2-1.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
1 written public comment to its subcommittee: February 7, 2024 (1) · on the Legislature’s site
Fiscal note
AI summary This bill specifies that court-ordered guardians have the authority to make end-of-life care decisions for the adults they protect. It is estimated to increase costs to the Department of Health and Human Services by approximately $129,000 per year.3
Read the fiscal note
Description
House File 2577 relates to end-of-life care under guardianships of adults by specifying what is included as a decision regarding a protected person’s health, including end-of-life decisions, for court-ordered guardians.
Background
Established in Iowa Code chapter 231E, the Office of Public Guardian (OPG) may act as an individual’s guardian, conservator, or representative payee. Under current law, a court may grant a guardian the ability to make decisions regarding the care, maintenance, health, education, welfare, and safety of the protected person except as otherwise limited by the court, which the guardian may exercise thereafter without prior court approval.
Assumptions
- The OPG anticipates increased costs of approximately $25 per client, per month, for between 110 and 220 existing clients resulting in an annual cost increase between $33,000 and $66,000. These fees are paid to the OPG by the Department of Health and Human Services (HHS).
- The OPG anticipates an additional one to two applications for public guardianship services per month with an average case opening fee of $2,500 and continuing costs of $350 per month for an estimated annual cost increase between $53,000 and $106,000.
- The OPG anticipates increased call volumes to Adult Protective Services, the expense of which is expected to be absorbed within current operating expenses.
Fiscal Impact
The total fiscal impact of HF 2577 would be approximately $129,000 per year in increased case costs to the HHS.
Sources
- Department of Health and Human Services
- Legislative Services Agency
- Guardianships, Hospice and End-of-Life Care and Decisions · March 6, 2024 · $129,000
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90th General Assembly