What's happening
This bill requires informed consent before administering psychotropic medications to nursing home and adult care facility residents, with specific disclosure and documentation requirements.
Why it matters
Empowers residents and their representatives. By requiring comprehensive written informed consent—including explanation of risks, benefits, and alternatives—before prescribing or increasing psychotropic medications, this bill gives residents and their families or appointed agents greater control and understanding over powerful drug interventions.
Addresses risks of inappropriate medication use. Elderly and vulnerable populations in care facilities are at heightened risk for overmedication or being prescribed psychotropic drugs for staff convenience rather than medical necessity; the bill’s consent process and documentation requirements are meant to reduce these practices and promote safer, more deliberate prescribing.
Creates safeguards and emergency exceptions. While prioritizing consent, the bill allows for exceptions in emergencies where medication is urgently needed to protect the health or safety of the resident or others, but still requires documentation and prompt notification to the patient or representative, ensuring accountability even in urgent situations.
Improves transparency and family involvement. The bill mandates that, when requested, family members are notified of new or increased psychotropic medication orders (unless the resident objects), potentially enhancing oversight and encouraging collaborative care decisions.
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Who cares
Headline styles
Limit Drug Use in Nursing Homes
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Print number 8752a
- Amend and recommit to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Limit Psychiatric Drugs in Nursing Homes
In Senate Committee · Rules · Sponsor Richard Gottfried
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
8752--A
IN SENATE
May 10, 2018
Introduced by Sen. SEPULVEDA -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT to amend the public health law, in relation to the use of psychotropic medications in nursing homes and adult care facilities
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The public health law is amended by adding a new section 280-d to read as follows:
§ 280-d. Use of psychotropic medications in nursing homes and adult care facilities. 1. As used in this section:
(a) "psychotropic medication" means a drug that affects brain activities associated with mental processes and behavior, including, but not limited to, antipsychotics, antidepressants, antianxiety drugs or anxiolytics, and hypnotics;
(b) "lawful representative" means, where a patient lacks capacity to consent to health care, a person authorized to consent on behalf of the patient, including, but not limited to, a health care agent authorized by a health care proxy under article twenty-nine-C of this chapter or a surrogate under article twenty-nine-CC of this chapter;
(c) "increase" when used in relation to an order for a psychotropic medication, means an increase of the dosage or duration of the medication above the dosage or duration covered by the currently active consent;
(d) "health care professional" means a health care professional, licensed, certified or authorized to practice under title eight of the education law, acting within his or her lawful scope of practice, who has authority to order a psychotropic medication; and
(e) "patient" means an individual who is a resident of a residential health care facility as defined in article twenty-eight of this chapter, or an adult care facility certified under section four hundred sixtyone-b of the social services law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02468-03-8
S. 8752--A 2
2. (a) An order for a psychotropic medication shall include the dosage, frequency, and duration of the order which shall not exceed fourteen days. A health care professional may not order or increase an order for a psychotropic medication for a patient unless the health care professional has obtained the written informed consent of the patient or the patient's lawful representative, or is acting pursuant to an order under this section, or is acting under subdivision three of this section. Where a patient lacks capacity to consent to health care and lacks a lawful representative, an order or increase of an order under this section shall be subject to subdivision four of section twenty-nine hundred ninety-four-g of this chapter as if the patient were an inpatient of a general hospital. To constitute informed consent, the following disclosure shall be given to the patient or, where the patient lacks capacity to consent to health care, the patient's lawful representative, in a clear and explicit manner:
(i) the reason for the medication, including the nature and seriousness of the patient's illness, disorder or condition that the medication is intended to treat;
(ii) the anticipated benefit from the medication, and the dosage, frequency, and duration of the order;
(iii) the probability of side effects and significant risks of the medication, including the nature, degree, and duration of such effects and reasonably known risks;
(iv) the reasonable alternative treatments to the proposed medication and the reason that the health care professional prefers the proposed medication in this instance; and
(v) that the patient or lawful representative has the right to consent or refuse consent to use of the proposed medication, and that if he or she consents, he or she has the right to revoke his or her consent for any reason, at any time, including a description of how the consent shall be revoked.
(b) The health care professional shall document in the patient's medical record the date and time that the informed consent disclosure was provided, and to whom and by whom it was provided, and include the written consent.
(c) Where the patient's medical record notes that a family member has requested notification of medication orders, and such notification is otherwise lawful, the health care professional shall cause notice to be provided within forty-eight hours of the prescription, order, or increase of an order under this section. Such notice shall not be provided if the patient specifically requests that the family member not be given notification.
3. A health care professional is not required to obtain consent under this section to issue an order for use of a psychotropic medication for a patient where it is reasonably necessary in an emergency to protect the life, health or safety of the patient or another person. Where an order is made under this subdivision, the health care professional shall immediately record the use of the psychotropic medication, the reason for the use, and the dosage, in the patient's medical record; and shall promptly notify the patient or the patient's lawful representative who would have had the authority to consent, and any family member required to be notified under this section and record such notifications in the patient's medical record.
4. This section does not increase the lawful scope of practice of any health care professional and does not diminish or impair any requirement for or regulation of consent to health care treatment.
S. 8752--A 3
5. The commissioner may make regulations to implement this section.
§ 2. This act shall take effect on the one hundred eightieth day after it shall have become a law; provided that, effective immediately, the commissioner of health is authorized to make regulations and take any other actions necessary to implement section 280-d of the public health law.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to the use of psychotropic medications in nursing homes and adult care facilities
Purpose or general idea of bill
to require an enhanced level of informed consent before psychotropic medication can be prescribed for patients residing in nursing homes or adult care facilities.
Summary of specific provisions
Would add a new section 280-d to article 2-A of the Public Health Law to detail the information that must be provided before a health care professional may prescribe a psychotropic medication and require a writ- ten informed consent before the initial order, or before an increase in the dose or duration of an existing order.
Read the full memo (662 words)
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 reasonably necessary to protect the life, health or safety of the patient or others, with prompt notification 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' interest to expose them to the dangerous side effects of psychotropic drugs, which include cogni- tive decline and addiction.
This bill would require that before such drugs are ordered for a patient residing in a nursing home or an adult care facility, the patient or their lawful surrogate be fully informed of the nature and seriousness of his or her 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. The consent would be written.
Adult care facilities, including assisted living and adult homes, share many similarities with nursing homes in terms of the needs, vulnerabili- ty and isolation of the residents. It is appropriate to extend the protections of this legislation to adult care facility residents.
Allowing family members beyond those who are already the health care agent or surrogate for the patient to require notification adds another layer of accountability and assures that patients' quality of life will be protected and optimized.
Reference: Left Behind: The Impact Of The Failure To Fulfill The Promise of The National Campaign To Improve Dementia Care; Long Term Community Care Coalition; 12/22/2014. 1
Prior legislative history
2015-2016: A.7351 - passed Assembly
Fiscal implications
None
Effective date
180 days after enactment provided that the Commissioner may make regu- lations beforehand that would become effective at the same time as the law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.