BILL NUMBER: S893A
SPONSOR: SEPULVEDA
 
TITLE OF BILL:
An act to amend the public health law, in relation to the use of psycho-
tropic medications in nursing homes and adult care facilities
 
PURPOSE:
This bill requires an enhanced level of informed consent before psycho-
tropic medication can be prescribed for patients in nursing homes.
 
SUMMARY OF PROVISIONS:
Section one adds a new section 280-d to the Public Health Law to detail
the information that must be provided before a health care professional
may prescribe a psychotropic medication to a patient in a nursing home
and require informed consent before the initial order or prescription.
The bill accommodates the need of patients who lack capacity and have
lawful representation by a health care agent or surrogate. It provides
notification within 48 hours of an order for a psychotropic medication
to family members who have requested and are lawfully permitted to
receive such notice. It establishes requirements for record keeping in
relation to such medication orders and the contingent informed consent.
Finally, the bill allows for an emergency order for psychotropic medica-
tion where it is necessary to protect the life, health or safety of a
nursing home patient or others in the nursing home, with prompt notifi-
cation to lawful representatives and family members lawfully permitted
to receive such notice.
 
JUSTIFICATION:
Under section 2803-c(3) of the Public Health Law, patients residing in
nursing homes have the right to be fully informed of their condition and
any proposed treatment, to refuse treatment, and to be free from chemi-
cal restraints unless such a prescription is consistent with certain
requirements that limit duration and guide use necessitated by an emer-
gency. Psychotropic medications are drugs that affect brain activities
associated with mental processes and behavior including antipsychotics,
antidepressants, antianxiety drugs and hypnotics.
Spurred by published reports, the Assembly Committee on Health held a
public hearing in February 2015 to examine the use of psychotropic drugs
in nursing homes. Consensus emerged that in far too many instances,
psychotropic drugs are used without a differential diagnosis of mental
illness, in order to quiet and calm patients who may be simply upset or
excitable. Given that activities and diversions have been proven to
effectively reduce disruptions related to simple anxiety, dementia and
emotional upset, it is not in many patients' interests to expose them to
the dangerous side effects of psychotropic drugs which include cognitive
decline and addiction. This bill would require that before such drugs
are ordered for a patient in a nursing home, the patient or their lawful
surrogate be fully informed of the nature and seriousness of their
condition, the anticipated benefit from the medication, the dosage and
duration of the prescription, the probability, nature and degree of side
effects, the reasonable alternatives to the drug and why the health care
professional prefers the drug in this instance, and that the patient has
the right to refuse consent for the drug, or later to revoke their
consent.
 
LEGISLATIVE HISTORY:
2023-2024: Amend and Recommit to Aging Print Number 466A.
2015-2016: A7351 - similar passed Assembly No Senate Bill
2017-2018: A5332 - similar passed Assembly Senate Health.
2019-2020: A1033 - similar passed Assembly Senate Health
2021-2022: A5841 - similar passed Assembly - Senate Health
2023-2024: S.466A - similar amended on third reading 7467B, Amended and
recommit to Aging Print Number 466A.
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
One year after enactment provided that the Commissioner may make regu-
lations beforehand that would become effective at the same time as the
law.