10/18/2025
I have submitted a proposed bill and received a response from a senator today. I am keeping my fingers crossed that we can successfully advance this legislation and raise awareness about the importance of addressing life-altering situations caused by professional negligence and medical malpractice.
Prayers and let's be heard 🙏 ♥️
The Patient Lifetime Compensation Act
A Legislative Proposal for the State of Iowa Date: October 13, 2025
1. Introduction/Statement of Purpose
Medical malpractice can result in catastrophic injuries that leave victims, particularly children, with a lifetime of complex and costly medical needs. While the current legal system provides for compensation through judgments and settlements, these often take the form of a single, lump-sum payment. Over the course of a lifetime, this initial amount can prove tragically insufficient due to the unpredictable nature of long-term medical care, rising healthcare costs, and unforeseen complications. This financial shortfall places an immense and unjust burden on families, forcing them to navigate endless financial hardship while caring for their loved ones, and often results in the cost being shifted to public assistance programs.
The purpose of The Patient Lifetime Compensation Act is to create a framework that ensures victims of catastrophic medical negligence receive the care they need for the entirety of their lives. This Act will shift the ongoing financial responsibility for care from the victim and the public to the healthcare provider or institution whose negligence caused the harm, thereby providing true, lifelong accountability and security for the most severely injured patients.
2. Key Provisions
A. Establishment of a Lifetime Care Trust In any medical malpractice action resulting in a judgment or settlement involving a catastrophic injury, the court shall order the establishment of a Patient Lifetime Care Trust. A “catastrophic injury” is defined as any injury that results in a permanent, severe functional disability, requiring lifelong medical treatment, rehabilitation, or custodial care. The funding of this trust by the defendant and/or their insurer shall be a mandatory component of the resolution.
B. Purpose of the Trust The sole purpose of the Patient Lifetime Care Trust shall be to pay for all reasonable and necessary medical expenses and care needs arising from the malpractice injury for the duration of the beneficiary’s life. Covered expenses include, but are not limited to: * Medical, surgical, and therapeutic treatments; * Rehabilitation services, including physical, occupational, and speech therapy; * Prescription medications and medical supplies; * In-home and residential custodial care; * Assistive technology, durable medical equipment, and necessary home or vehicle modifications.
C. Funding and Administration The Trust shall be fully funded by the defendant(s) or their insurer(s) in an amount determined by the court, based on a comprehensive life care plan submitted by the plaintiff. The Trust shall be managed by a neutral, court-appointed professional trustee with expertise in administering special needs or settlement trusts. The trustee shall be responsible for evaluating the reasonableness and necessity of expenses and making direct disbursements to healthcare and service providers, ensuring accountability and proper use of funds.
D. Relation to Settlement/Judgment The Patient Lifetime Care Trust is established to cover future medical and care-related expenses only. It shall be separate from, and in addition to, any other damages awarded to the victim. The establishment of this Trust shall not limit the victim’s right to receive compensation for other economic damages, such as lost future earnings, or non-economic damages, such as pain, suffering, and loss of enjoyment of life.
E. No Reversion of Funds Upon the death of the beneficiary, any funds remaining in the Patient Lifetime Care Trust shall not revert to the defendant, their insurer, or any other party responsible for funding the trust. The remaining assets shall be distributed to the beneficiary’s estate or, alternatively, be directed to a state-administered fund dedicated to supporting victims of medical negligence and promoting patient safety initiatives.
3. Justification
The current system of lump-sum payments is an inadequate solution for lifelong injuries. It forces families to predict the unpredictable: the precise arc of medical inflation, the emergence of new and costly treatments, and the potential for secondary health complications decades after the initial injury. Damage caps further restrict the ability of a jury to award a sum that can truly meet these future needs. When these funds are exhausted, the financial burden falls upon the victim’s family and, ultimately, on public resources such as Medicaid. This is a fundamental injustice.
The Patient Lifetime Compensation Act corrects this flaw by aligning the duration of the remedy with the duration of the harm. It ensures that the negligent party bears the full, actual cost of the injury they caused, for as long as that cost exists. This approach provides financial security to the family, guarantees the victim receives necessary care without interruption, and protects taxpayer resources from being used to subsidize the consequences of medical negligence. By placing the true long-term cost on the responsible parties, this Act also creates a powerful incentive for healthcare providers and institutions to invest in and prioritize patient safety to prevent such devastating errors from occurring.
4. Conclusion
True justice for victims of catastrophic medical malpractice is not a one-time payment; it is a lifetime of security and care. The Patient Lifetime Compensation Act offers a just, sustainable, and responsible solution that protects the most vulnerable among us. It ensures that the promise of a legal remedy is not eroded by time and unforeseen costs. We urge the Iowa Legislature to consider and enact this vital proposal to provide genuine peace of mind and fairness to families who have already endured unimaginable hardship.
