Bill Text: NY A07467 | 2023-2024 | General Assembly | Amended


Bill Title: Relates to the use of antipsychotic medications in nursing homes; imposes limits as to time and documentation; requires informed consent under certain circumstances.

Spectrum: Partisan Bill (Democrat 35-0)

Status: (Introduced - Dead) 2024-05-23 - amended on third reading 7467b [A07467 Detail]

Download: New_York-2023-A07467-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         7467--B
                                                                Cal. No. 409

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                      May 24, 2023
                                       ___________

        Introduced by M. of A. PAULIN, SAYEGH, STECK, SIMON, COOK, GLICK, VANEL,
          LUNSFORD,   L. ROSENTHAL,   BRONSON,   ZEBROWSKI,   THIELE,  WILLIAMS,
          BICHOTTE HERMELYN, CARROLL, FALL, GALLAGHER,  FORREST,  CRUZ,  STIRPE,
          CLARK, COLTON, SANTABARBARA, HUNTER, JACKSON, ZINERMAN, KELLES, JACOB-
          SON,  OTIS,  WALLACE,  MEEKS,  SILLITTI, GUNTHER, WEPRIN, RAGA -- read
          once and referred to the Committee on Health -- reported and  referred
          to  the  Committee  on Codes -- reported from committee, advanced to a
          third reading, amended and ordered reprinted, retaining its  place  on
          the  order of third reading -- again amended on third reading, ordered
          reprinted, retaining its place on the order of third reading

        AN ACT to amend the public health law, in relation to the use  of  anti-
          psychotic medications in nursing homes

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The public health law is amended by adding  a  new  section
     2  280-d to read as follows:
     3    §  280-d.  Use  of  antipsychotic medications in nursing homes.  1. As
     4  used in this section:
     5    (a) "lawful representative" means, where a resident lacks capacity  to
     6  consent  to health care, a person authorized to consent on behalf of the
     7  resident, including, but not limited to, a health care agent  authorized
     8  by  a health care proxy under article twenty-nine-C of this chapter or a
     9  surrogate under article twenty-nine-CC of this chapter; and
    10    (b) "health care  professional"  means  a  health  care  professional,
    11  licensed,  certified  or authorized to practice under title eight of the
    12  education law, acting within  such  health  care  professional's  lawful
    13  scope  of  practice, who has authority to order an antipsychotic medica-
    14  tion.
    15    2. (a) A nursing home or a health care professional shall  obtain  the
    16  informed  consent  of  the  resident  or the resident's lawful represen-
    17  tative, before initiating the administration of an antipsychotic medica-

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01548-08-4

        A. 7467--B                          2

     1  tion for a  resident,  provided  that  informed  consent  shall  not  be
     2  required in the case of:
     3    (i)  a  resident  who  has been prescribed an antipsychotic medication
     4  prior to an admission or readmission to the nursing home;
     5    (ii) a resident who has previously provided  informed  consent  within
     6  the last twelve months;
     7    (iii) a resident receiving hospice care;
     8    (iv) a resident of a nursing home's certified behavioral unit;
     9    (v) a resident with a primary diagnosis of Huntington's disease; or
    10    (vi) an emergency as defined in subdivision three of this section.
    11    (b)  Where  a  resident  lacks  capacity to consent to health care and
    12  lacks a lawful representative, a prescription under this  section  shall
    13  be  subject  to  subdivision four of section twenty-nine hundred ninety-
    14  four-g of this chapter as if the resident were an inpatient of a general
    15  hospital. To constitute informed consent, the following disclosure shall
    16  be given to the resident  or,  where  the  resident  lacks  capacity  to
    17  consent to health care, the resident's lawful representative, in a clear
    18  and explicit manner:
    19    (i)  the  reason for the medication, including the nature and serious-
    20  ness of the resident's illness, disorder or condition that  the  medica-
    21  tion is intended to treat;
    22    (ii)  the  anticipated  benefit  from  the medication, and the dosage,
    23  frequency, and duration of the order;
    24    (iii) the probability of side effects and  significant  risks  of  the
    25  medication,  including  the nature, degree, and duration of such effects
    26  and reasonably known risks;
    27    (iv) the reasonable alternative treatments to the proposed  medication
    28  and the reason that the prescribing health care professional prefers the
    29  proposed medication in this instance; and
    30    (v)  that  the  resident  or  lawful  representative  has the right to
    31  consent or refuse consent to use of the proposed medication, and that if
    32  such resident or lawful representative consents, such resident or lawful
    33  representative has the right to revoke such resident's or lawful  repre-
    34  sentative's consent for any reason, at any time, including a description
    35  of how the consent shall be revoked.
    36    (c)  The  health  care  professional  shall document in the resident's
    37  medical record the date and time that the  informed  consent  disclosure
    38  was provided, and to whom and by whom it was provided.
    39    (d) Where the resident's medical record notes that a family member has
    40  requested  notification  of medication orders or prescriptions, and such
    41  notification is otherwise lawful, the  health  care  professional  shall
    42  cause  notice to be provided within forty-eight hours of the order under
    43  this section. Such notice shall not be provided if the resident  specif-
    44  ically requests that the family member not be given notification.
    45    3. A nursing home and a health care professional shall not be required
    46  to  obtain  consent  under  this section to issue an order for use of an
    47  antipsychotic medication for a resident in a nursing home  where  it  is
    48  necessary  in an emergency to protect against an immediate threat to the
    49  life, health or safety of the resident or another person.   The  medica-
    50  tion  must  be  the  most  appropriate  available means of reducing that
    51  threat, with the least risk of harm considering the resident's condition
    52  or disorder. The order shall only apply,  in  the  absence  of  consent,
    53  during the emergency. Where an order is made under this subdivision, the
    54  health  care  professional shall immediately record the use of the anti-
    55  psychotic medication, the reason for the use, and  the  dosage,  in  the
    56  resident's medical record; and shall promptly notify the resident or the

        A. 7467--B                          3

     1  resident's  lawful  representative  who  would have had the authority to
     2  consent, and any family  member  required  to  be  notified  under  this
     3  section and record such notifications in the resident's medical record.
     4    4.  This section does not increase the lawful scope of practice of any
     5  health care professional and does not diminish or impair any requirement
     6  for or regulation of consent to health care treatment.
     7    5. The commissioner may make regulations to implement this section.
     8    § 2. This act shall take effect one year after it shall have become  a
     9  law. Effective immediately, the addition, amendment and/or repeal of any
    10  rule  or  regulation necessary for the implementation of this act on its
    11  effective date are authorized to be made and completed on or before such
    12  effective date.
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