S-5122

   Amend House File 2305, as amended, passed, and reprinted by the House, as follows:
   1.  Page 1, by striking lines 9 through 23.
   2.  Page 1, line 24, by striking <2.  4.> and inserting <2.>
   3.  Page 1, line 31, by striking <3.  5.> and inserting <3.>
   4.  By striking page 1, line 33, through page 2, line 2.
   5.  Page 2, line 3, by striking <4.  7.> and inserting <4.>
   6.  Page 2, by striking lines 8 through 10 and inserting <received admission into the a hospice program. If the patient is unable to request admission, a family member the patient’s attorney in fact as defined in section 144B.1, or the patient’s guardian appointed pursuant to chapter 633, or the majority of the guardians if the patient has more than one guardian appointed with equal responsibilities, may voluntarily request and receive admission on the patient’s behalf.>
   7.  Page 2, line 11, by striking <5.  8.> and inserting <5.>
   8.  Page 2, line 17, by striking <6.  9.> and inserting <6.>
   9.  Page 2, line 29, by striking <7.  10.> and inserting <7.>
   10.  Page 3, line 8, by striking <8.  11.> and inserting <8.>
   11.  Page 3, line 23, by striking <12.> and inserting <9.>
   12.  Page 3, line 27, by striking <13.> and inserting <10.>
   13.  Page 3, line 29, by striking <14.> and inserting <11.>
   14.  Page 3, line 31, by striking <15.> and inserting <12.>
   15.  Page 4, line 24, by striking <A> and inserting <1. If a patient does not have an attorney in fact as defined in section 144B.1, or a guardian appointed pursuant to chapter 633, a>
   16.  By striking page 4, line 28, through page 5, line 23, and inserting:  <a hospice program by an individual, in the same order of priority prescribed in section 144A.7, subsection 1, who shall be guided by the express or implied intentions of the patient and who is reasonably available, willing, and competent to make the decision.
   2.  This section shall not apply to a guardian appointed under chapter 232D.>
   17.  Page 6, by striking lines 4 and 5 and inserting <patient “Attorney in fact” means an individual who is designated by a durable power of attorney for health care as an agent to make health care decisions on behalf of a patient and has consented to act in that capacity.>
   18.  Page 6, by striking lines 6 and 7 and inserting: 
   <5.  “Close adult friend” means a friend of a patient to whom all of the following apply:
   a.  The individual is at least eighteen years of age.
   b.  The individual has shown special care and concern for the patient.
   c.  The individual maintains regular contact with the patient and is familiar with the patient’s health, activities, and beliefs.
   d.   The individual has provided an affidavit to the patient’s attending provider that states that the individual is willing and able to be involved in the patient’s care.>
   19.  Page 6, by striking lines 12 and 13 and inserting: 
   <8.  “Durable power of attorney for health care” means a document authorizing an attorney in fact to make health care decisions for a patient if the patient is unable, in the judgment of the patient’s attending provider, to make health care decisions.> 
   20.  Page 9, by striking lines 25 through 30 and inserting <or advanced registered nurse practitioner, and the patient’s attorney in fact as defined in section 144B.1, or the patient’s guardian appointed pursuant to chapter 633. If the patient has more than one guardian with equal responsibilities appointed, the decision agreed to by a majority of the guardians. If a majority consensus is not achieved by the guardians, a court order shall be required. If a patient does not have an attorney in fact as defined in section 144B.1, or a guardian appointed pursuant to chapter 633, the decision may be made by any of the following individuals, who shall be guided by the express or implied intentions of the patient, in the following order of priority if no individual in a prior class the previous priority is reasonably available, willing, and competent to act make the decision:>
   21.  By striking page 9, line 31, through page 10, line 7.
   22.  Page 10, line 8, by striking <c.> and inserting <a.>
   23.  Page 10, line 9, by striking <d.> and inserting <b.>
   24.  Page 10, line 13, by striking <e.> and inserting <c.>
   25.  Page 10, line 17, by striking <f.> and inserting <d.>
   26.  Page 10, line 21, by striking <g.> and inserting <e.>
   27.  Page 10, line 26, by striking <h.> and inserting <f.>
   28.  Page 11, line 21, by striking <illness> and inserting <condition>
   29.  By striking page 11, line 27, through page 12, line 22, and inserting <assistant, or advanced registered nurse practitioner, and the patient’s attorney in fact as defined in section 144B.1, or the patient’s guardian appointed pursuant to chapter 633. If the patient has more than one guardian appointed with equal responsibilities, the decision agreed to by a majority of the guardians. If a majority consensus is not achieved by the guardians, a court order shall be required. If a patient does not have an attorney in fact or a guardian, the decision may be made by an individual, in the same order of priority prescribed in section 144A.7, subsection 1, who shall be guided by the express or implied intentions of the patient and who is reasonably available, willing, and competent to make the decision.>
   30.  Page 12, before line 27 by inserting: 
   <3.  This section shall only apply to a patient located in a health care facility as that term is defined in section 135C.1, or a health facility as that term is defined in section 135P.1.>
   31.  Page 15, after line 14 by inserting: 
   <Sec. ___.  Section 633.669, subsection 1, paragraph b, Code 2026, is amended by adding the following new subparagraphs:
   NEW SUBPARAGRAPH.  (11)  The protected person’s wishes related to withholding or withdrawal of life-sustaining procedures pursuant to chapter 144A or 144D.
   NEW SUBPARAGRAPH.  (12)  The protected person’s wishes related to placement in a hospice program in the event of a terminal condition.
   Sec. ___.  Section 633.669, subsection 1, paragraph c, Code 2026, is amended by adding the following new subparagraphs:
   NEW SUBPARAGRAPH.  (9)  The protected person’s wishes related to withholding or withdrawal of life-sustaining procedures pursuant to chapter 144A or 144D.
   NEW SUBPARAGRAPH.  (10)   The protected person’s wishes related to placement in a hospice program in the event of a terminal condition.>
   32.  Title page, by striking lines 3 through 4 and inserting <out-of-hospital do-not-resuscitate orders, durable powers of attorney for healthcare, and probate court guardianship reports.>
   33.  By renumbering, redesignating, and correcting internal references as necessary.

______________________________
COMMITTEE ON HEALTH AND HUMAN SERVICES

KARA WARME, CHAIRPERSON